Objective To investigate the value of three-dimensional color power angio(3D-CPA)in the prenatal diagnosis of pernicious placenta previa (PPP ) with placenta increta.Methods The ultrasonographic findings of PPP with placenta increta diagnosed in our hospital by 2D-CDFI and 3D-CPA were reviewed and compared with pathologic histology examination.For each of the two imaging methods, sensitivity,specificity,positive predictive value and prenatal diagnose accordance rate were summarized. Results For 3D-CPA,sensitivity,specificity and positive predictive value were 91.1%,88.9% and 93.3%, respectively.The results of 3D-CPA were higher than those in 2D-CDFI (sensitivity 76.4%,specificity 66.7%,positive predictive value 81.5% ),and were statistically significant (P <0.05 ).The diagnose accordance rate of 3D-CPA was statistically higher than that of 2D-CDFI (90.4% vs 73.0%;P <0.05). Conclusions 3D-CPA can display abnormal vascular reconstruction between the placenta and uterine wall from various angles,and is more accurate than 2D-CDFI.3D-CPA plays an important role in the prenatal diagnosis of PPP with placenta increta.

Cytokines ; metabolism ; Humans ; Leukocytes, Mononuclear ; immunology ; secretion ; Ubiquitin ; blood

Osteoarthritis (OA) is the main reason of joint pain and dysfunction in the elderly in China, and its incidence is increasing year by year. In addition to the joint peripheral osteophyte formation and degeneration of articular cartilage, in?flammation, as one of the dominant pathological changes in OA, is causing more and more attention. Pro-inflammatory cyto?kines (PIC) are important mediators of inflammation. The increased level of PIC in OA can lead to systemic and local inflam?mation, results in further destruction of many kinds of tissues in joint (such as cartilage), and accelerates the development of OA. Besides, the severity of inflammation is closely related to the clinical symptoms of OA. Therefore, it is important to un?derstand the role of PIC in the pathogenesis of OA. From the perspective of the relationship between pro-inflammatory fac?tors and OA and the molecular mechanism, this article reviews the research progress in this field, which provides new con?cepts for diagnose and treatment of OA.

Delightful achievements have been obtained in forestry genetic breeding since the application of transgenic technology in this field during the past 20 years. Field trials of some genetic modified (GM) trees have been carried out, and some GM trees have been commercialized. Meanwhile, the risks of ecological safety caused by GM trees have raised attention in the public gradually. These issues mainly include the horizontal transfer and vertical flow of foreign genes, and the potential effects on insects, soil ecosystems and virus. The current status of field trials, commercial applications and the potential ecological risks of GM trees were summarized. Then the prospects of GM trees were also presented.

A PCR method was used to amplify the sequence encoding the mature peptide of?-mannanase of Bacillus subtilis. The gene was inserted into the Pichia pastoris vector pPIC9K, downstream of?-factor signal peptide sequence. The resultant recombinant plasmid pPIC9K-MAN was lineared by BglII digestion and introduced into the host Pichia pastoris GS115 by PEG method. After screen, the recombinant P. pastoris strain MAN22 was obtained and fermented in large scale 5L fermenter. The recombinant mannanase activity could reach to 1102IU/ml. The properties of the recombinant mannanase were characterized.

In this paper, the effect of 5% (V/V) n-alkanes (e.g, n-Heptane, n-Octane, n-Decane, n-Dodecanen-Tetradecane and n-Hexadecane) on the growth and protease production of organic-solvent-tolerant- bacte-rium Bacillus licheniformis YP1 was studied. 5%(V/V) n-alkanes had no effect on the stability of YP1 prote-ase. 5% (V/V) n-alkanes had no notable influence on the yield of strain YP1 but dramatically affected theprotease production. The presence of n-Heptane, n-Octane and n-Decane deeply repressed the protease pro-duction; however n-Dodecane, n-Tetradecane and n-Hexadecane enhanced the protease production promi-nencely. The concentration of n-Tetradecane (1%-8%, V/V) had a direct ration with the protease production.The detailed experiments showed that the notable increase of protease activity appeared at the late logarithmof cultivation compared with the blank. The cell shape of YP1 strain remarkably decreased when grown inthe presence of n-Tetradecane. This is the first report about the effect of n-alkanes on the protease productionby the solvent tolerant bacterium.

OBJECTIVETo evaluate effects of different treatments on patients with osteoporotic vertebral fracture after percutaneous kyphoplasty in pain and function.

METHODSFrom March 2010 to March 2012,138 patients (165 vertebrae) with thoracic and lumbar vertebral osteoporotic fracture were randomly divided into three groups (control group, treatment group and comprehensive group), 46 cases in each group, and all patients were treated by PKP. Control group were treated with calcium and calcitriol after operation, treatment group added salmon calcitonin see calcimar based on control group, comprehensive group added incrementality waist musculi dorsi function exercise based on treatment group. VAS, ODI scores and BMD before operation, 3 d, 2 weeks, 1 month, 6 months and 12 months after operation were detected and compared.

RESULTSAll operation were performed successfully,38 cases (45 vertebrae) in control group, 36 cases (44 vertebrae) in treatment group and 40 cases (49 vertebrae) were obtained complete following up, there was no significant meaning in following time among three groups (P>0.05). Postoperative VAS and ODI scores at 3 d, 2 weeks and 1 month among three groups were lower than that of before operation (P<0.01). Compared with control group, postoperative VAS score at 3 d, 2 weeks and 1 month were decreasedin treatment group and comprehensive group, but there was no significant meaning in ODI scores (P>0.05). At 6 and 12 months after operation,there was no significant differences in VAS and ODI between control group and treatment group (P>0.05), while VAS score in comprehensive group decreased much than other two groups,decreased continuously (P<0.01). At 12 months after operation, BMD among three groups were increased more than preoperative,and BMD in comprehensive group was more obviously than that of in control and treatment group.

CONCLUSIONPKP, an effective method for the treatment of thoracic and lumbar vertebral osteoporotic fracture, could improve short-term clinical effects by adding calcitonin with calcium supplements and activated vitamin D. Waist musculi dorsi function exercise could improve long-term clinical effects of PKP and improve quality of life.

Aged ; Female ; Humans ; Kyphoplasty ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Quality of Life ; Thoracic Vertebrae ; injuries ; surgery ; Treatment Outcome

Objective To analyse the effects of serum estradiol levels during controlled ovarian hyperstimulation (COH) on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods The clinical data of 472 patients undergoing IVF-ET with GnRH analogues recombinant FSH long protocol were retrospectively analysed. The area under the curve (AUC) of estradiol (E2) level was calculated during COH, and patients were categorized into groups according to the percentile of AUC of E2(AUCE2) during COH. The general characteristics and parameters related to the outcomes of IVF-ET were compared among groups. Results The 10th percentile and 90th percentile of AUCE2 were 3 347.0 pmoL/L and 14 414.3 pmol/L, respectively. Four hundred and seventy-two patients were divided into lower reaction group (AUCE2 3 347.0 pmol/L, n=48), normal reaction group (14 414.3 pmol/L>AUCE2 > 3 347.0 pmol/L, n=376) and higher reaction group (AUCE2≥14 413.3 pmol/L, n=48). There was no significant difference in age, body mass index, baseline follicle stimulating hormone level, time of treatment with gonadotropin, endometrium thickness on day of transfer and embryos transferred(P>0.05). Compared with lower reaction group and normal reaction group, the number of oocytes per retrieval and number of embryos frozen were significantly larger(P<0.01) and the mild/severe ovarian hyperstimulation syndrome rate was significantly higher in higher reaction group(P<0.05). There was no significant difference in fertilization rate, cumulative embryo score, high-grade embryo rate, clinical pregnancy rate and implantation rate among groups (P> 0.05). Conclusion Sustained snpraphysiological serum E2 levels during the COH process do not adversely affect the quality of oocytes and embryos, clinical pregnancy rate and implantation rate to some extent in IVF-ET.

Objective To discuss the operative methods and cnrative effect of calcaneal tuberosity fracture.Methods The data of 15 patients with calcaneal tuberosity fracture was retrospectively analyzed who received treatment between January 2008 and June 2011.There were 9 males and 6 female,with the age ranging from 31 to 68 years (average,51.4 years).All the patients had unilateral acute injury,with the left foot in 7 cases and the right foot in 8 cases.According to the Beavis classification,there were 3 cases in type Ⅰ and 12 cases in type Ⅱ.All the cases in type Ⅰ and 10 cases in type Ⅱ were treated with open reduction and screw fixation.The other 2 cases in type Ⅱ with larger fragment involving a portion of the subtalar joint were treated with plate and screw fixation.The effect of the treatment was assessed according to the ankle and hindfoot score system of American Orthopaedic Foot and Ankle Society (AOFAS) after the operation.Results Ten patients were followed up for 12 to 36 months (average,20 months).The healing time in these patients ranged from 8 to 25 weeks (average,12 weeks).The postoperative score ranged from 47 to 100 points (average,91.1 points).There were 7 cases which received excellent effect,2 cases,good,and 1 case,poor.The rate of excellent and good was 90％.Necrosis of skin and soft tissue and exposure of the plate happened to one patient,who eventually healed after 3 weeks by debridement with plate preserved and peroneal artery perforator flap transplantation.Loss of reduction happened to another patient,who was treated with the revision surgery by open reduction and screw fixation again.Conclusion To patients with obvious Fracture displacement whose soft tissues are irritated severely.Emergency open reduction and internal fixation operation should be offered to prevent the necrosis of the flaps as far as possible.To patients with small fractures,it is advisable to choose open reduction and large diameter screw fixation,while plate and screw fixation may be better for patients with larger tuberosity fragment,especially when the fracture line extends to the facet of the subtalar joint.

Objective To retrospectively assess clinical outcomes of buttress plating in fixation of posterior pilon fractures.Methods The study involved 16 cases of posterior pilon fractures that had undergone buttress plate fixation between January 2005 and December 2009.There were 11 males and 5 females,at mean age of 37.6 years (range,23-62 years).All cases received radiography,CT scan and three-dimensional reconstruction preoperatively.Posterior malleolar fragments were reduced and fixed through posterolateral approach or combined approach (posteromedial plus posterolateral approaches) based on effect area of fracture line on CT films.Clinical and radiographic examinations were performed in postoperative follow-up.Clinical outcomes were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS).Results Posterior pilon fractures were classified into 3 types according to CT scans.Fourteen cases were followed up for average 37.6 months (range,16-52 months).Mean AOFAS score was 86.4 points (range,70-98 points) and mean VAS score was 1.4 points (range,0-3 points).All cases received favorable functional outcomes without hardware failure,except that one patient still suffered from peri-ankle swelling and long term walking discomfort two years after operation.Conclusion Buttress plating is effective in treatment of posterior pilon fractures and can facilitate early weight-bearing functional exercise.