Objective To explore the function of placental trophoblast cell apoptosis on the pathogenetic mechanism of pregnancy induced hypertension (PIH). Methods Apoptosis of trophoblast cells in 20 cases of PIH(PIH group) and in 10 cases of normal pregnancy (control group) were directly observed using the terminal-deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL) method. Apoptosis gene expression patterns were screened with gene chip provided by Poxing Company, Shanghai. Standards for differently expressed genes were: (1) An absolute value of the natural logarithm of cy5(PIH group)/cy3(control group) greater than 0.69 with a difference of signal of cy5 2 times over that of cy3. (2) The signal value either cy3 or cy5 must be greater than 800. Results (1) TUNEL test showed that the number of trophoblast cells apoptosis per ten thousand ?m 2 was 1.584 in the PIH group and 0.032 in the control group with significant difference between the two groups (P

ObjectiveTo investigate application value of parametric image processing in contrastenhanced ultrasound imaging in diagnosis of ovarian masses. MethodsFifty cases with ovarian masses underwent routine ultrasound and contrast-enhanced ultrasound imaging using a new dedicated parametric image processing software SonoLiver to analyze patterns of vascular formation and blood stream perfusion in the ovarian mass tissues on a digital video recorder in real time, compare their morphological characteristics of time-intensity curve (TIC) and dynamic vascular patterns (DVP) curve, and analyze quantitatively all indicators generated by SonoLiver.ResultsIn ultrasound imaging of the 50 cases, there were 24 cases (86％) displaying mainly blue lowly-enhanced imaging in those with benign masses and 15 cases (68％)displaying mainly red highly-enhanced imaging in those with malignant masses, with statistical significance (P ＜0. 01 ). There was significantly different characteristics of TIC and DVP between patients with benign and malignant masses. In 23 cases with benign masses, their DVP were significantly higher above the baseline than in those with malignant ones ( P = 0. 000), and in 15 cases with malignant lesions, their DVP were much shorter below the baseline than in those with benign ones, with statistical significance (P ＜0.05). The intensity of contrast medium, the time to reach its peak intensity and average transit time were all significantly higher in those with malignant masses than in those with benign ones (all P ＜ 0. 05 ). But, no statistical difference in the time of initial increasing between the two groups was found (P ＞ 0. 05). ConclusionsThere is significant difference in TIC and DVP of ultrasound imaging between benign and malignant masses, which if combined with contrast enhanced ultrasound parametric image processing can provide a more visualized quantitative information of benign and malignant ovarian masses with SonoLiver software.

Interleukin family plays an important role in cleating the infection of Toxoplasma gondii in the body of host such as destroying the infected cells,constructing immunity system and regulating immunity balance,and so on.Here we reviewed the role of several important interleukin family members so as to provide scientific basis for the treatment of Toxoplasma gondii infection.

In order to successfully develop the effective population pharmacokinetic model to predict the concentration of propofol administrated intravenously, the data including the concentrations across both distribution and elimination phases from five hospitals were analyzed using nonlinear mixed effect model (NONMEM). Three-compartment pharmacokinetic model was applied while the exponential model was used to describe the inter-individual variability and constant coefficient model to the intra-individual variability, accordingly. Covariate effect including the body weight on the parameter CL, V1, Q2, V2, Q3 and V3 were investigated. The performance of final model was assessed by Bootstrapping, goodness-of-fit and visual predictive checking (VPC). The context-sensitive half-times and the infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were simulated to six subpopulations. The results were as follows: the typical value of CL, V1, Q2, V2, Q3 and V3 were 0.965 x (1 + 0.401 x VESS) x (BW/59)(0.578) L x min(-1), 13.4 x (AGE/45)(-0.317) L, 0.659 x (1 + GENDER x 0.385) L x min(-1), 28.8 L, 0.575 x (1 + GENDER x 0.367) x (1 - 0.369 x VESS) L x min(-1) and 196 L respectively. Coefficients of the inter-individual variability of CL, V1, Q2, V2, Q3 and V3 were 29.2%, 46.9%, 35.2%, 40.4%, 67.0% and 49.9% respectively, and the coefficients of residual variability were 24.7%, 16.1% and 22.5%, the final model indicated a positive influence of a body weight on CL, and also that a negative correlation of age with V1. Q2 and Q3 in males were higher than those in females at 38.5% and 36.7%. The CL and Q3 were 40.1% increased and 36.9% decreased in arterial samples compared to those in venous samples. The determination coefficient of observations (DV)-individual predicted value (IPRED) by the final model was 0.91 which could predict the propofol concentration fairly well. The stability and the predictive performance were accepted by Bootstrapping, the goodness-of-fit and VPC. The context-sensitive half-times and infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were different obviously among the 6 sub-populations obviously. The three-compartment model with first-order elimination could describe the pharmacokinetics of propofol fairly well. The involved fixed effects are age, body weight, gender and sampling site. The simulations in 6 subpopulations were available in clinical anesthesia. The propofol anesthesia monitor care could be improved by individualization of pharmacokinetic parameter estimated from the final model.

Objective To investigate the correlation between pelvic organ prolapse quantitation (POP-Q) indication points and the incidence of occult stress urinary incontinence (OSUI) and its impact on prognosis. Methods Retrospective study medical records of 93 patients with pelvic organ prolapse (POP) staged atⅢ-Ⅳ, of which underwent pelvic reconstruction operations with Prolift system from Jan. 2007 to Sept. 2012. None of these patients had clinical manifestations of stress urinary incontinence (SUI) before surgery, and in which 44 patients were included in study group (POP complicated with OSUI) because they were identified with OSUI, another 49 patients as control group (simple POP). Follow-up and collecting datas including POP-Q, stress test, urodynamic recordings, incidence of de novo SUI, statistic analyzing by logistic regression and receiver operating characteristic curve (ROC). Results (1) The study group had a much higher incidence of 30%(13/44) on de novo SUI than that of control group (4%, 2/49;P<0.01). (2) Vaginal delivery (OR=5.327, 95%CI:1.120-25.347), constipation (OR=5.789, 95%CI:1.492-22.459), preoperative OSUI (OR=13.695, 95%CI:2.980-62.944), anterior vaginal wall prolapse (OR=6.115, 95%CI:1.231-30.379) were identified as dependent risk factors for de novo SUI by logistic regression analysis. (3) For POP patients that complicated with OSUI, we chose a cutoff value of +1.5 cm for Aa point as the threshold to predicting incidence of de novo SUI according to ROC curve, area under the curve (AUC) was 0.889 (P<0.05), the sensitivity reached 88.9%and specificity was 73.9%. According to ROC curve of Ba point, a cutoff value of+2.5 cm was chosen as the threshold to predicting incidence of de novo SUI post-operation, it had a sensitivity of 66.7% and specificity of 82.6%, AUC was 0.766 (P<0.05). Conclusions Pre-operative OSUI is a dependent risk factor of de novo SUI for advanced POP patients. Aa and Ba points are correlated with preoperative OSUI, and it is worthy to be considered as a risk predictor on forecasting the incidence of de novo SUI post pelvic reconstruction surgery.

Objective To explore the effect of emergency nursing combined with predictive rehabilitation nursing on rehabilitation and prognosis of patients with acute stroke. Methods One hundred and thirty patients with acute stroke admitted to Zhejiang Hospital from June 2017 to December 2018 were enrolled, and they were divided into an emergency nursing group and a combined nursing group according to different nursing methods, 65 cases in each group. The emergency nursing group was given emergency nursing; and the combined nursing group was given emergency nursing combined with predictive rehabilitation nursing. After 2 weeks, the clinical efficacy was evaluated. The neurological function, motor ability, cognitive function, activities of daily living, clinical efficacy and the incidence of complications were observed in the two groups. Results After treatment, the scores of American National Institutes of Health Stroke Scale (NIHSS) in two groups was significantly lower than that before treatment, the scores of simple Fugl-Meyer motor function (FMA) and simple intelligent mental state examination scale (MMSE), Barthel index (BI) were obviously higher than those before treatment, and the changes of the above indexes in the combined nursing group were more significant than those in the emergency nursing group after treatment (NIHSS score: 13.68±4.01 vs. 19.47±3.82, FMA score: 31.65±4.11 vs. 26.47±4.53, MMSE: 25.34±3.71 vs. 20.07±3.08, BI: 54.68±7.01 vs. 47.37±6.51), the differences were statistically significant (all P < 0.05). The total effective rate of the combined nursing group was significantly higher than that of the emergency nursing group [90.77% (59/65) vs. 75.39% (49/65), P < 0.05], and the incidence of complications in the combined nursing group was obviously lower than that in the emergency nursing group [21.51% (14/65) vs. 40.00% (26/65), P < 0.05]. Conclusion The emergency nursing combined with predictive rehabilitation nursing has good clinical effect on patients with acute stroke, it can effectively elevate the neurological function, motor ability, cognitive function and daily living ability, improve blood lipid and coagulation function indicators, reduce the incidence of complications, facilitate rehabilitation and improve prognosis.

OBJECTIVETo study the effect of BRCA1 in regulating the proliferation and migration of breast cancer cells stimulated by progesterone.

METHODSBreast cancer MCF-7 and T-47D cell were transfected with a vector containing the coding sequence of BRCA1 (pFlag-CMV2-BRCA1 wt) to induce BRCA1 overexpression or with the empty vector (control). The cells were then stimulated with progesterone, and the cell proliferation and migration were observed using MTT assay and wound healing assay, respectively. The proliferation and migration of MCF-7 cells were also observed following transfection with a small interfering RNA (siRNA) for BRCA1 knockdown or with a scrambled siRNA prior to progesterone stimulation.

RESULTSTransfection with the empty vector and with pFlag-CMV2-BRCA1 wt prior to progesterone stimulation caused significantly different proliferation rates in MCF-7 cells [(114.4∓6.0)% vs (82.1∓3.2)%, P<0.05] and in T-47D cells [(111.3∓4.3)% vs (84.2∓3.5)%, P<0.05], resulting also in significantly different cell migration rates (55.9% vs 15.8% in MCF-7 cells and 44.83% vs 10.43% in T-47D cells). Compared to the scrambled siRNA, BRCA1 siRNA transfection prior to progesterone stimulation significantly increased the proliferation rates [(114.4∓3.05)% vs (125.3∓4.0)%, P<0.05] and migration rate (39.2% vs 69.08%) of MCF-7 cells. The progesterone antagonist RU468 could antagonize the effects of BRCA1 knockdown in enhancing progesterone-stimulated MCF-7 cell proliferation and migration.

CONCLUSIONA decreased BRCA1 expression can enhance progesterone-stimulated tumor cell proliferation and migration in sporadic breast cancer.

BRCA1 Protein ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Female ; Genetic Vectors ; Humans ; Progesterone ; pharmacology ; RNA, Messenger ; genetics ; Receptors, Progesterone ; antagonists & inhibitors ; Transfection

Objective To quantitatively detect circulating DNA levels in the plasma of patients withcervical lesion and to determine the value for diagnosis of cervical lesion and cervical cancer . Methods Preoperative blood samples were collected from 53 cases of low-grade lesions, 49 cases of high-grade lesions, 44 cases of cervical invasive cancer and 70 cases of healthy women. Plasma DNA was extracted by magnetic bead method (BILATEST DNA kit). The quantity of plasma DNA was determined by duplex real-time quantitative PCR. Results Median plasma DNA level of invasive cervical cancer patients was 61. 59 mg/L (32. 06 - 162. 16 mg/L) , which was significantly higher than that of healthy women [16. 35 mg/L(11. 98 -22.71 mg/L), P < 0.01]. Among invasive cervical cancer patients, median plasma DNA level of squamous carcinoma patients was slightly higher than that of adenocarcinoma (50. 43 versus 47. 31 mg/L,P>0. 05). Median plasma DNA level of stage I patients was lower than that of stage Ⅱ- Ⅲ patients (46. 02 versus 71. 35 mg/L, P <0. 05). Conclusion Quantitatively detecting plasma circulating DNA may be with some application prospect in the diagnosis of cervical diseases.

Objective:Explore the main measures and operation mechanism to improve the scientific and technological innovation capacity of district and county hospitals by taking advantage of medical consortium, to achieve the goal of targeted poverty alleviation.Methods:Combine the practical exploration and empirical study on the main measures and operating mechanism to improve the scientific and technological innovation capacity of district and county hospitals, pre-and post comparison were conducted to analyze the effectiveness.Results:During the construction of medical consortium, a district-level general hospital has seen obvious increase in the comparison of many achievement indicators of scientific and technological innovation, with the growth rate ranging from 66.67% to 700%.Conclusions:Based on medical consortium, the operation mechanism that takes discipline construction as the starting point and key discipline establishment as the target, Scientific and technological innovation incubation platform, incentive mechanism and regular summary and evaluation can encourage district and county hospitals to improve scientific and technological innovation ability.

Objective:To explore the role of clinical pharmacists participating in the management of prophylactic antibiotics during the perioperative period of thoracic surgery, and to evaluate the effects after participating in the practice.Methods:The use of antimicrobials during the perioperative period of thoracic surgery in Wenjiang Hospital of Sichuan Provincial People's Hospital in August 2019 (pre-practice) was retrospectively analyzed. The existing problems were summarized, and the possible causes of the existing problems were analyzed. The improvement measures were jointly developed by clinical pharmacists and physicians. Clinical pharmacists continued to manage the use of antimicrobials by means of medication order reviews, ward rounds for pharmacy service, and medication training. The use of prophylactic antibiotics during the perioperative period of thoracic surgery was compared between August 2019 (pre-practice group) and December 2019 (post-practice group) and the practical effect was evaluated.Results:Clinical pharmacists reviewed perioperative patients' medication orders once a day, ward rounds for pharmacy service twice a week, and medication training once a month. Twenty-two patients were enrolled before practice, and 26 patients were enrolled after practice. There were no significant differences in age, sex, body weight, operative time, type of surgical incision, and preventive use of antibiotics between the two groups (all P > 0.05). In the post-practice group, the appropriate time for preoperative administration was 100.0%, which was significantly higher than 88.2% in the pre-practice group. The reasonable rate of preoperative preventive drug selection was 100.0%, which was significantly higher than 44.4% in the pre-practice group ( χ2 = 17.50, P < 0.001). In the post-practice group, the duration of preventive medication was (1.82 ± 0.59) days, which was significantly shorter than (7.54 ± 3.25) days in the pre-practice group ( t = 11.97, P < 0.001). In the post-practice group, the cost of antibacterial drugs was 316.00(237.00,454.25) yuan, which was significantly lower than 1 136.00(391.81 , 2 184.65) yuan in the pre-practice group ( Z = -2.78, P < 0.05). The defined daily dose of antibiotics among inpatients was 2.67(2.00,3.42), which was significantly lower than 8.88(3.92 , 19.18) in the pre-practice group ( Z = -3.26, P < 0.05). There were no significant differences in the incidence of postoperative pulmonary infection and total length of hospital stay between the two groups (both P > 0.05). Conclusion:Clinical pharmacists participating in the management practice of perioperative prophylactic antibiotics in thoracic surgery can effectively promote the rational application of perioperative antibiotics, markedly improve the reasonable rate of prophylactic drug delivery, shorten the course of prophylactic drugs, reduce the cost of antibiotics, decrease the defined daily dose of antibiotics, without increasing the risk of postoperative pulmonary infection and the total length of hospital stay.