Objective To analyze the changes of thyroid function of healthy primipara before 20 weeks of gestation to establish normal gestational age-specific reference interval of thyroid hormones,and to investigate the prevalence of maternal thyroid disorders during the first half of pregnancy.Methods A total of 1605 healthy primipara without risk factors of thyroid diseases before 20 gestational weeks and 200 non-pregnant healthy women who accepted pre-conception care in Beijing Friendship Hospital from September 2010 to June 2011 were tested for serum thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antihody (TPOAb) by chemiluminometric immunoanalysis.One thousand two hundred and fourty-three pregnant women among them with negative thyroid antibooly and without previons thyroid diseases were selected as the standard population for normal interval.Gestational age-specific percentile categories for TSH and FT4 were calculated.The prevalence of maternal thyroid disorders was examined by gestational agespecific intervals.Results (1) Compared with non-pregnant women,the median value of serum TSH in pregnant women decreased by 29.56％ to the value of 0.91 mU/L; while that of FT4 rose by 7.79％ to the value of 11.33 pmol/L before 12 weeks; and TSH increased while FT4 decreased during 13 to 20 weeks.(2) The median values and reference intervals (2.5th percentile,97.5th percentile) for TSH were 1.59 mU/L (0.15 mU/L,5.19 mU/L) in no-pregnant women,1.12 mU/L (0.03 mU/L,3.67 mU/L) at 8-12+6 gestational weeks,1.21 mU/L (0.05 mU/L,3.74 mU/L) at 13-16+6 gestational weeks,1.50 mU/L (0.31 mU/L,4.33 mU/L) at 17-19+6 gestational weeks; and the median values and reference intervals (2.5th percentile,97.5th percentile) for FT4 were 9.91 pmol/L (6.69 pmol/L,14.03 pmol/L),10.68 pmol/L (7.98 pmol/L,18.66 pmol/L),10.04 pmol/L (6.18 pmol/L,16.22 pmol/L),9.40 pmol/L (6.44 pmol/L,13.51 pmol/L) respectively.(3) According to gestational age-specific reference intervals,the general prevalence of maternal thyroid disorders,including hyperthyroidism,hypothyroidism,subclinical hypothyroidism and hypothyroinemia,was 3.55％ (57/1606).At 8-12+6 gestational weeks,13-16+6 gestational weeks and 17 19+6 gestational weeks,the occurrence of hyperthyroidism was 0.00％,0.13％ and 0.00％;that of hypothyroidism was 0.00％,0.13％ and 0.00％; the incidence of subclinical hypothyroidism was 3.60％,2.76％ and 3.00％; the occurrence of hypothyroxinemia was 0.16％,0.26％ and 0.86％,respectively.The positive rate of TPOAb at 8-12+6,13-16+6 and 17-19+6 gestational weeks were 22.91％ (140/611),16.56％ (126/761) and 15.45％(36/233),and the total positive rate of TPOAb was 18.82％ (302/1605).The median level of TPOAb was 38.90,41.87 and 39.10 mU/L,respectively.Conclusions Before 20 gestational weeks,specific changes occur in maternal thyroid function.TSH level decreases during 8 to 12 gestational weeks,and then increases gradually; while FT4 level increases during 8 to 12 weeks,and then decreases gradually.Thyroid dysfunction during pregnancy is common and subclinical hypothyroidisum is the leading problem in thyroid disorders.Screening for thyroid function during early pregnancy is suggested.

OBJECTIVE To know the principles of the transformations of the spatial directions in the view of the 0~ sinus endoscope and to simulate the space in endoscope using SkechUp software. METHODS The ideal model of the nasal cavity was designed and observed by the 0?rod-lens telescope. The space of the model in the endoscope was simulated using SkechUp.The principles of the transformations of the spatial directions were observed,which consisted of the lateral horizontal line (Lhn,n=0-6),the lateral vertical line (Lvn,n=0-9),the top horizontal line (Thn, n=0-9) and the lateral angle line (LAL).The location of the horizon was observed.RESULTS If the elevation angle (between the endoscope and bottom of nasal cavity) of the endoscope entering the model was unchanged and the distance of the endoscope entering the model was increased gradually,the positions of Lhn,Lvn and Thn in the visual field of the endoscope were replaced by Lh (n+1),Lv (n+1) and Th (n+1) respectively.The positions of Lhn,Lvn and Thn had repeatable characteristics.One horizontal plane in the space can become a horizon in the view and the location of the horizon in the view was invariable.If the distance of the endoscope entering the model was unchanged,the endoscope was moved to produce15?,30?,45?,60?elevation angle gradually,the positions of LAL (15?,30?,45?,60?) had the symmetry and repetition and the position of the horizon in the view was variable.CONCLUSION The directions of Lh and Lv and the locations of the horizon in the view of the 0?endoscope are correlative with the elevation angle of the endoscope,not pertinent to the distance of the endoscope coming into the nasal cavity.The directions of the space in the visual field of the endoscope have the symmetry and repeatable characteristics.Simulating the space in the visual field of the endoscope using SkechUp software provides the bases for the operation.

OBJECTIVE To study the benefits of applying digital visible models for endoscopic nasal surgery.METHODS CT data sets of 16 patients were segmented to create digital visible models by using AutoCAD(computer aided design),MOI (Moment of Inspiration) and SketchUp software package.Standard digital available data sets for clinical tasks such as surgical simulation and surgical planning.The digital visible models and the intra-and postoperative corresponding visions were compared. RESULTS The 3D structure model of nasal cavity, sinuses and their adjacent structures for endoscopic nasal surgery were successfully reconstructed.The models allowed the user to interact with the data and manipulate them(in the view of X-ray,looking around inside the model).The model can be observed during operation,provided accurate morphological data for surgery guidance plan.CONCLUSION The method creating digital visible models using AutoCAD,MOI and SketchUp software package is simple and feasible.The digital visible models are suitable for clinical use as well as for education of endoscopic nasal surgery.The benefit of this technology was confirmed by clinicians.

Objective To investigate the in-stent restenosis after vertebral artery ostium stenting (VAOS),and to determine the risk factors for in-stent restenosis. Methods Respective analysis of clinical data of 775 cases received VAOS in Xuan Wu Hospital of Capital Medical University from Jan. 2006 to Dec. 2012. Severe stenosis of vertebral artery ostium were diagnosed by DSA,and followed-up by ultrasound. The risk factors were assessed by COX analysis for in-stent restenosis ≥50%. Results This study included 775 patients. Surgical success rate was 99. 87%(n=774),technique success rate was 99. 48%(n=771 ). Two patients had cerebral hemorrhage after operation,one of them was dead. Four patients had cerebral infarction. The mean follow-up period was 12 months. The restenosis rate was 35. 89%(234/652 ). 79. 91% of restenosis occurred within 12 months after operation. COX analysis showed the vessels diameter after stenting was the independent predictors of in-stent restenosis (P<0. 01). The in-stent restenosis rate of drug-eluting stents was lower than metal-bare stents (HR 0. 532,95%CI 0. 397-0. 713,P<0. 01). Conclusion The in-stent restenosis was peculiarly prone to the smaller vessels diameter after VAOS. Drug-eluting stents were superior to metal-bare stents in preventing in-stent restenosis.

OBJECTIVETo explore the role of ompT gene in uropathogenic E. coli (UPEC) CFT073 strain in urinary tract infection (UTI).

METHODSAn ompT deletion mutant (COTD) was generated by λ Red recombineering in the UPEC CFT073 strain, which was characterized by PCR and sequencing. C57B/L6 mouse models of acute UTI with the mutant and wild-type strains were established to compare the colonization abilities of the two strains in the bladder. The adhesion of CFT073 mutant to human unthelial 5637 cells was also investigated in vitro.

RESULTSPCR and DNA sequencing confirmed the loss of ompT gene in the mutant COTD. The in vitro adhesion rate of the mutant strain COTD to 5637 cells was (6.7±2.2)%, significantly lower than that of (8.3±1.9)% of the wild-type strain (P<0.05). In the murine models of acute UTI, the mutant strain showed a mean colonization number of about (17±8)×10⁴ cfu, which was significantly lower than that of (7∓2)×10⁵ cfu of the wide-type CFT073 strain (P<0.05).

CONCLUSIONOmpT gene can be involved in the colonization of UPEC in the bladder tissue and plays an important role in the pathogenesis of UPEC-induced UTI.

Animals ; Bacterial Proteins ; genetics ; Cell Line ; Escherichia coli Infections ; microbiology ; Escherichia coli Proteins ; genetics ; Gene Knockout Techniques ; Humans ; Mice ; Mice, Inbred C57BL ; Porins ; genetics ; Urinary Tract Infections ; microbiology ; Uropathogenic Escherichia coli ; genetics

Objective To explore the role of CD44 in monocyte adhesion to human brain microvascular endothelial cells (HBMECs) and monocyte migration across an in vitro model of blood-brain barrier (BBB) infected by Cryptococcus neoformans (Cn). Methods An in vitro blood-brain barrier model was constructed using a transwell chamber covered with a HBMEC monolayer. The wild-type strain of Cn B4500FO2, TYCC645#32 strain with CPS1 gene deletion and PCIP strain with CPS1 complementation were chosen to infect the monolayer HBMECs. THP-1 cells were added to the upper chamber of transwell, and the relative migration rate was determined by counting the number of the cells entering the lower chambers. The inhibitory effects of anti-CD44 monoclonal antibody and the CD44 inhibitor bikunin were examined on THP-1 binding to and migration across HBMECs. Results Cn infection of the HBMECs caused markedly enhanced THP-1 cell adhesion and migration across the monolyers (P<0.01) dependent on Cn concentration and exposure time. Addition of anti- CD44 monoclonal antibody and bikunin significantly lowered THP-1 adhesion and migration rates in the BBB model with Cn-infected HBMECs (P<0.01) with a dose dependence of the antibody (within 0-1μg) and inhibitor (within 0-20 nmol/L). Both THP-1 adhesion rate and migration rate were lowered in the BBB model infected with CPS1 gene-deleted Cn but increased in the model infected with the complemented strain compared with those in the wild-type strain-infected model. Conclusion In the in vitro BBB model, CD44 expressed on HBMECs may play an essential role in monocyte adhesion to and migration across the BBB. The capsular hyaluronic acid may mediate Cn-induced monocyte adhesion and migration.

Objective To explore the role of CD44 in monocyte adhesion to human brain microvascular endothelial cells (HBMECs) and monocyte migration across an in vitro model of blood-brain barrier (BBB) infected by Cryptococcus neoformans (Cn). Methods An in vitro blood-brain barrier model was constructed using a transwell chamber covered with a HBMEC monolayer. The wild-type strain of Cn B4500FO2, TYCC645#32 strain with CPS1 gene deletion and PCIP strain with CPS1 complementation were chosen to infect the monolayer HBMECs. THP-1 cells were added to the upper chamber of transwell, and the relative migration rate was determined by counting the number of the cells entering the lower chambers. The inhibitory effects of anti-CD44 monoclonal antibody and the CD44 inhibitor bikunin were examined on THP-1 binding to and migration across HBMECs. Results Cn infection of the HBMECs caused markedly enhanced THP-1 cell adhesion and migration across the monolyers (P<0.01) dependent on Cn concentration and exposure time. Addition of anti- CD44 monoclonal antibody and bikunin significantly lowered THP-1 adhesion and migration rates in the BBB model with Cn-infected HBMECs (P<0.01) with a dose dependence of the antibody (within 0-1μg) and inhibitor (within 0-20 nmol/L). Both THP-1 adhesion rate and migration rate were lowered in the BBB model infected with CPS1 gene-deleted Cn but increased in the model infected with the complemented strain compared with those in the wild-type strain-infected model. Conclusion In the in vitro BBB model, CD44 expressed on HBMECs may play an essential role in monocyte adhesion to and migration across the BBB. The capsular hyaluronic acid may mediate Cn-induced monocyte adhesion and migration.

Objective:To explore the correlation of bone marrow polychonal plasma cell proportion (pPC% ) and clinical features in newly diagnosed multiple myeloma (NDMM) patients.Methods:A retrospective analysis of 317 patients with NDMM admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2018 to January 2023 was performed. The results of the pPC% in all patients were clear. The relationship between the pPC% and clinical characteristics was analyzed.Results:A total of 317 patients were included, comprising 180 males and 137 females. The median age at diagnosis was 61 (26-91) years, and 55.8% were 60 years or older. The pPC% in the bone marrow of patients with NDMM was different in the DS, International Staging System (ISS), and revised ISS (R-ISS) stages ( P=0.002, 0.010, and 0.049, respectively), whereas no statistical difference in pPC% was observed among patients with different FISH risk stratigrams ( P=0.971). The correlation coefficient between pPC% and hemoglobin (HGB) at the first diagnosis in patients was 0.211 ( P<0.01). The correlation coefficients with serum calcium, serum creatinine, M protein level, and β 2-microglobulin were -0.141, -0.120, -0.181, and -0.207, respectively, and the results of the significance test were P=0.012, 0.033, 0.004, and 0.002, respectively, indicating a negative correlation. Compared with the patients with a pPC% of ≥2.5%, the group of patients with a pPC% of <2.5% had significantly higher levels of light chain, serum calcium, serum creatinine, M protein, and β 2-microglobulin at the initial diagnosis ( P<0.05) ; lower HGB level ( P<0.001) ; and a higher proportion of patients in ISS stage Ⅲ ( P=0.034) . Conclusion:In this study, the pPC% in patients with NDMM was associated with clinical features of good prognosis, including higher HGB, lower serum calcium, serum creatinine, M protein quantity, β 2-microglobulin, light chain involvement, lower proportion of advanced disease (DS stage and ISS stage Ⅲ), and clinical features showing lower tumor burden.