Objective To investigate the efficacy of methotrexate combined with mifepristone prophylaxis for persistent ectopic pregnancy (PEP) after laparoscopic conservative surgery. Methods One hundred and twenty cases of tubal pregnancy were randomly divided into two groups by admission number, the study group (60 cases) were treated by mifepristone before laparoscopic conservative surgery and methotrexate combined with mifepristone after laparoscopic conservative surgery, but the control group (60 cases) were treated by laparoscopic conservative surgery, the bleeding was observated in the surgery,concentration of β-human chorionic gonadotrop ( β-hCG) was detected before operation and 1,3,7,12 d after operation. Results There were significant differences in β-hCG after operation 3,7,12 d between two groups(P<0.05). The bleeding was (21.8 ?.2) ml in study group,and (38.1 ?3.1) ml in control group, there was significant difference between two groups (P<0.05). In study group, the incidence of PEP was 0, and 3.33%(2/60) in control group. Conclusion Preoperative mifepristone and postoperative mifepristone combined with methotrexate in preventing PEP after laparoscopic conservative surgery is efficacy, and it can be chosen in clinic.

Objective To investigate the effect of community nursing intervention on hypertension combined with diabetes in elderly patients.Methods Five hundred and twenty elderly hypertensive patients with diabetes aged over 60 years in 10 communities of Shenzhen were randomly divided into a control group and a study group,260 cases in each group.All the patients in the two groups were given regular follow-ups in community clinics after discharge.Then the control group received instructions on relevant knowledge by the nurses in the community clinics,while the study group received nursing intervention by phone calls or visits by professional nurses once a month.The two groups were compared in terms of blood pressure,blood sugar and blood lipids 12 months after intervention.Results There were no significant differences in blood pressure,blood sugar and blood lipids between the two groups before the intervention(all P>0.05).After intervention,however,the differences were significant(all P<0.05).Conclusion Community nursing intervention may effectively improve hypertension and diabetes in the elderly patients by improving the levels of blood pressure,blood glucose and blood lipid,thereby reducing the incidence of cardiovascular and cerebrovascular events.

Objective:To investigate the efficiency of CBCT in the diagnosis of impacted maxillary anterior teeth and the treatment effect of different guided eruption methods. Methods:34 impacted maxillary anterior teeth in 30 patients were examined by panoramic films and CBCT, the dental crowns, root, eruption space and other related items were measured and compared between 2 examinations. 20 cases were treated by closed guided eruption and traction( CGET) technique, 10 cases by circumferential supracrestal fibrotomy and exposed traction( CSF-EE) , results were compared. Results: CBCT was more effective than panoramic films in the revelation of tooth root bending, apical pore closure and eruption measurements(P<0. 05). 7-10 d after treatment 5 out off the 10 casses treated by CSF-EE showed different degrees of clinical crown elongation, poor gum appearance and low height of alveolar ridge as insufficient periodontal attachment. However, the treatment of CGET for 26 teeth (76. 47% of all cases) was highly successful and received very satisfactory re-sults, the rest 8 teeth (23. 53% of all cases) showed mediocre satisfaction. Conclusion: CBCT can accurately display the position, shape, relation with adjacent teeth of the impacted teeth. Closed guided eruption and traction is more effective for the treatment.

Objective To investigate the level of alpha-synuclein (α-syn) oligomers in peripheral blood plasma and red blood cells (RBC) in patients with Parkinson's disease (PD), and the value of it for diagnosis and evaluation of PD. Methods From March, 2013 to De-cember, 2014, peripheral blood samples were collected from 30 PD patients and 30 healthy coutrols, and the level ofα-syn oligomers in plas-ma and RBC was detected with enzyme linked immunosorbent assay. Results The level of α-syn oligomers was less in both plasma and RBC in the controls than in the patients (t>2.346, P<0.05), and was more in RBC than in plasma in both the controls and the patients (t>2.242, P<0.05). The level ofα-syn oligomers of patients did not correlate with their course, Hoehn-Yahr Stage, the scores of Unified Parkin-son Disease Rating Scale Part 3, Non-Motor Symptom Quest and Mini-Mental State Examinatlon, both in plasma and RBC (P>0.05). Con-clusion The level ofα-syn oligomers in peripheral RBC and plasma may be helpful for diagnosis of PD, but less for the evaluation of the ill-ness.

[Objective] To explore the relationship between TCM syndrome patterns and physicochemical parameters of chronic obstructive pulmonary disease (COPD). [Methods] Five hundred hospitalized cases of COPD were investigated. The correlation of TCM syndrome patterns with pulmonary function, blood analysis and biochemical indexes were assayed by logistic forward regression analysis and linear multiple regression analysis, and then the above indexes were analyzed by independent- samples t test. [Results] Five equations were obtained by logistic regression. Positive correlation was found between the number of white blood cells (WBC) and the pattern of phlegm-heat blocking lung, hemoglobin (HGB) level and the pattern of yang deficiency with fluid retention, as well as red cell distribution width (RDW) and the pattern of kidney deficiency. Maximal expiratory flow rate in residual 75 % vital capacity ( MEF75), peak of expiratory flow (PEF) and mean corpuscular hemoglobin (MCH) were negatively correlated with the pattern of yang deficiency with fluid retention. Maximal expiratory flow rate in residual 25% vital capacity (MEF25) and granulocyte percentage (GP) were also negatively correlated with the pattern of spleen deficiency. So did potassium ions (K+ ) level and the pattern of kidney deficiency, t test showed the same results. [Conclusion] The above indexes have great value for TCM syndrome differentiation of COPD.

Magnetic induction method aims at the noninvasive detection of liver iron overload by measuring the hepatic magnetic susceptibility. To solve the difficulty that eddy current effects interfere with the measurement of magnetic susceptibility, we proposed an improved coil system based on the static field magnetization principle in this study. We used a direct current excitation to eliminate the eddy current effect, and a rotary receiver coil to get the induced voltage. The magnetic field for a cylindrical object due to the magnetization effect was calculated and the relative change of maximum induced voltage was derived. The correlation between magnetic susceptibility of object and maximum magnetic flux, maximum induced voltage and relative change of maximum induced voltage of the receiver coil were obtained by simulation experiments, and the results were compared with those of the theory calculation. The contrast shows that the simulation results fit the theory results well, which proves our method can eliminate the eddy current effect effectively.
Computer Simulation ; Humans ; Image Processing, Computer-Assisted ; Iron Overload ; diagnosis ; Liver ; physiopathology ; Magnetic Fields ; Magnetics ; instrumentation

Objective To investigate the perinatal outcomes and management of pregnancy with leukemia.Methods From June 1,1980 to July 31,2011,23 pregnant women with leukemia,were admitted to the Department of Obstetrics of Peking University People's Hospital.Clinical data of these women were collected and analyzed retrospectively.Among the 23 cases,nine were diagnosed before pregnancy including four with acute myeloid leukemia (AML) and five with chronic myeloid leukemia (CML),and 14 diagnosed during pregnancy including eight with acute leukemia (AL) [seven with AML and one with acute lymphocytic leukemia (ALL)] and six with CML.The prognosis of the mothers and infants were followed up.Results (1)Managements during pregnancy:For the four cases with AML,two were completely recovered and the other two had completed chemotherapy five years before pregnancy,and no relapse was reported during pregnancy.The other five cases with CML were stable during pregnancy although the results of blood routine tests were abnormal.Among them,one case was treated with hydroxyurea and one with imatinib during pregnancy,while the other three women received no treatment.For those 14 cases diagnosed during pregnancy,all were recorded with abnormal white blood counts,and nine complicated with anemia and abnormal platelet count and four with either anemia or abnormal platelet count.Among the eight cases with AL,six received chemotherapy during pregnancy and two did not due to intrauterine fetal death and 40 weeks of gestation on admission,respectively.For the six CML women,two received hydroxyurea,one took imatinib,one took leukapheresis and one accepted plateletpheresis during pregnancy,but one woman received no treatment due to regular contractions on admission.(2) Perinatal outcomes:The average gestational weeks on delivery was (38.3±2.3) weeks,and the average birth weight of newborns was (2 755 ±486) g.There were two cases of disseminated intravascular coagulation,five pre-eclampsia and one placental abruption during pregnancy.Five women were complicated with postpartum hemorrhage [average bleeding volume was (1 200± 751) ml] and two cases of puerperal infection.One pregnant woman died.Among the 23 perinatal infants,there were four premature infants,four low birth weight infants,two still births,one with congenital malformations,and two infants had abnormal blood routine tests.Eight babies were delivered by caesarean section,12 through vagina and two required forceps assistants.(3) Follow-ups:Except for one woman died during pregnancy,four of the other 22 cases were lost.Among the rest 18 cases with the follow-up from three months to 13 years,11 women survived and seven died due to leukemia.All newborns were healthy.Conclusions Pregnancy with leukemia is an extremely high-risk obstetric condition,but for patients with bearing requirement,better perinatal outcome might be achieved under proper management.

Objective To evaluate the association between methylenetetrahydrofolate reductase gene (MTHFR) C677T polymorphism and diabetic kidney disease in Chinese population.Methods After searching the related literatures from PubMed,Medline,EMBASE databases and common Chinese journal literature databases,meta-analysis was performed to assess the association of MTHFR C677T polymorphism with diabetic kidney disease according to the principles of systematic review based on the recessive model and dominant model respectively.Fixed effect model (M-H) was used to pool odd ratio (OR) after heterogeneity test.The Begg and Egger analysis were conducted to evaluate the publication bias.Results 10 literatures including a total of 2018 cases were included in the metaanalysis.No significant heterogeneity was detected.Data were pooled by fixed effect model.The total OR was 2.41 (95％CI=1.85～3.13) and 2.33 (95％CI=1.82～2.98) in recessive and dominant models respectively.No obvious publication bias was observed by Begg and Egger analysis.Conclusions The T allele of C677T polymorphism in MTHFR gene is positively associated with diabetic kidney disease in Chinese population.

BACKGROUND: Environment pollution due to lead is severe day by day,and the lead-induced developmental toxicity of central nervous system is prominent.OBJECTIVE: To observe the effect of lead at low exposure level on neurobehavioral function of preschool children and provide basis for preventing childhood behavior disorders.DESIGN: Sampling survey.SETTING: Department of Children and Adolescent Health, Public Health College, Sun Yat-sen University.PARTICIPANTS: Totally 211 children of 4-6 years (109 boys and 102girls) were enrolled from a kindergarten of a populated area of Zhuhai City by randomized cluster sampling from September to October 2004.METHODS: 20 mL peripheral blood of finger tip was collected. Blood lead was determined with graphite stove atomic absorption spectrometry.According to the amount of blood lead, the children were divided into high blood lead exposure group (＞100μg/L) and low blood lead exposure group (＜100μg/L). Furthermore, they were also assigned into ＜50 μg/L group, 50μg/L- group, 100μg/L- group, 150 μg/L- group, 250- μg/L group. Achenbach's Child Behavior Checklist (CBCL) and self-designed questionnaire (composed of possibly effective factor on children's neurobehavioral function, such as age, sex, cultivation, family background and so on) were applied, filled by their parents under the instruction of professional staffs. Results and blood lead value were analyzed with first order correlation and multiple factors stepwise regressive analysis.MAIN OUTCOME MEASURES: ①Blood lead level and each factor scores of CBCL, ②correlation analysis between blood lead value and behavioral factor score.RESULTS: A total of 211 questionnaires were sent out, and 211 were retrieved with 211 effective questionnaires. The effective rate was 100%. ①Score on externalizing and behavioral disorder rate in the high blood lead exposure group (13.28±6.26,18.26%) was significantly higher than those in the low blood lead exposure group (9.98±5.46,7.29%)( t=4.067 7,χ2=5.470, P＜0.05). There was insignificant difference in score on internalizing and total score of CBCL between the low and high blood lead exposure groups. ②The behavioral disorder rate of different blood lead level had significance (χ2=13.695,P＜0.01). The behavioral disorder rate in blood lead ≥ 150 μg/L was obviously higher than that of the former 3groups after further pairwise comparison (χ2 were 4.727, 6.261, 5.168;4.503, 5.911, 4.928, P＜0.05), which revealed that the child behavioral disorder rate markedly increased when the blood lead was ≥ 150 μg/L.③Blood lead logarithm value had positive correlation with the scores on hyperactivity, aggression and defiance (r=0.316 4,0.282 8,0.188 6,P ＜0.05), and had no correlation with obesity, desintegration, truculence and sexual questionnaire (r=0.102 4,0.094 2,0.118 3,0.092 6,P ＞ 0.05). ④After the stepwise regression analysis, the scores on hyperactivity, aggression and defiance factors were included in the regression equation. The results suggested that the effect of lead on child externalizing behavior still remained, and kept statistical meaning after confounding factors, such as controlling family and society, etc.CONCLUSION: Low-level lead exposure has adverse effects on externalizing behavior in preschool children.

Objective To investigate the clinical characteristics, the antenatal management, the outcome and prognosis of chronic myeloproliferative disorders (CMPD) complicating pregnancy. Methods Retrospectively analyze the clinical data of eleven patients with CMPD complicating pregnancy hospitalized in Peking University People' s Hospital from 2000 to 2009, including five patients with essential thrombocythemia, one with primary myelofibrosis and five with chronic myeloid leukemia. Results (1)Five pregnancies had periodic antenatal care and laboratory monitorings like full blood count. Reasonable anti-coagulation therapy was given to prevent the complications. One patient with PMF diagnosed before conception had her first pregnancy ended with mild pre-eclampsia and intrauterine death at the gestational age of 32 weeks. During the first trimester of her second pregnancy two years later, the test for anti-β2 glycoprotein antibody was positive. She received low-dose aspirin and low-molecular-weight heparin as anticoagulants. An uneventful course was obtained and she delivered a healthy term infant. (2) Five pregnancies had occasional antenatal examination, including two patients with ET and three patients with CML One patient with ET developed severe pre-eclampsia at the gestational age of 25 weeks. Umbilical artery Doppler showed reversed end-diastolic velocity. The management with anti-convulsants, antihypertensives and anti-coagulants showed no effect. An emergency cesarean section had to be performed because of the aggressive hypertension and placental abruption, with still birth as a result. Two pregnancies never had an antenatal care. Both of them were admitted on labor and the diagnoses of CML were made. (3)Four pregnancies developed oligohydramnios and three developed preelampsia(two severe pre-eclampsia and one mild pre-eclampsia). There was no other hemorrhage and thrombosis event. (4) Eight pregnancies reached full-term with four cesarean sections and four vaginal births. Two preterm cesarean sections were performed because of a progressive oligohydramnios. The ten live neonates weighed 1820 - 3600 g. All were appropriate for gestational age, except one fetal growth retardation (FGR) developed in one patient with severe pre-eclampsia. (5) As for the CMPD, the eleven patients were all in stable conditions. Three patients with CML received hydroxyurea in the third trimester, four with ET and one with CML had plateletpheresis before delivery with favorable effect. All patients were uneventful postpartum, except one with CML who died in 5 months after childbirth. Conclusions The pregnancy outcomes for patients with CMPD are mostly good. However, antenatal care should pay more attention to the complications such as thromboembolic accidents, pre-eclampsia, still birth and fetal growth retardation. Management including reasonable anticoagulation therapy should be considered, which may help improve the prognosis.