Objective To investigate the risk factors of adverse pregnancy outcome of women in China by Meta analysis.Methods Meta analysis was used to analyze the influencing factors of adverse pregnancy outcomes from January 2010 to January 2015.According to the inclusion and exclusion criteria,124 articles were retrieved,and 38 articles were excluded.14 papers were included in this study.Results There was strong correlation between fetal abnormalities and adverse pregnancy outcomes.And the maternal history of abortion and adverse pregnancy outcomes were not related.There was strong association between multiple pregnancy,syphilis infection and adverse pregnancy outcome,and there was moderate correlation between the high blood pressure in pregnancy and adverse pregnancy outcome.Abnormal fetal position,the OR value was 3.48 (2.70 -4.43),history of abortion OR value was 1.14 (0.90 -91.44),gestational hypertension OR value was 2.88 (1.69 -4.92),multiple births OR value was 6.40 (2.05 -20.01),syphilis OR value was 5.54 (1.64 -18.64).Conclusion The risk factors of adverse pregnancy outcomes from strong to weak are as follows:multifetal pregnancy,syphilis infection,abnormal fetal position and hyper-tensive disorder complicating pregnancy.

Objective To determine whether focal adhesion kinase (FAK) signal pathway was involved in migration of hepatocarcinoma cells by inhibiting focal adhesion kinase (FAK) phosphorylation in HepG2 cells with focal adhesion related nonkinase (FRNK). Methods The recombinant of FRNK and pEGFP-C2, an endogenous inhibitor of FAK activation,was transfected into HepG2 cells. HepG2 migration was examined by transmembrane assay. FAK and phosphatinositol 3-kinase (PI3-K) phosphorylation were detected by immunoprecipitation method. Confocal scanning microscopy was used to verify nuclear translocation of nuclear factor-kappa B (NF-?B). Results The transfection of FRNK recombinant plasmid could inhibit HepG2 migration, FAK and PI3-K phosphorylation decreased by 50.2 percent and 39.5 percent respectively. Furthermore, NF-?B translocation was down-regulated from 3.495?0.227 to 1.182?0.106. Conclusion These results suggested FAK was a main signal pathway in mediating HepG2 migration. Over expression of FRNK might inhibit signal transduction of FAK via depression of the phosphorylation of PI3-K and NF-?b activation, resulting in the decrease in migration of hepatocarcinoma cell.

Objective:To produce monoclonal antibodies(McAb) against aspergillus fumigatus and to establish rapid assay for the measurement of aspergillus fumigatus antigen.Methods:Recombinant galactomannoprotein of aspergillus fumigatus(AFMP1) was used to immune BALB/c mice.Monoclonal antibodies against AFMP1 were produced from hybridoma.Results:Three hybridomas producing antibodies against AFMP1 were obtained.IgG isotypes of three McAb were IgG1,IgG2a and IgG2b.The affinity constants(K) were 1.2?10 10 ,4.56?10 9 and 1.81?10 10 mol/L.The antibodies were proved to be specific for aspergillus fumigatus by Western blot and recognized different epitopes on AFMP1 by the additivity assay.An sandwich enzyme-linked immunosorbent assay(ELISA) to detect AFMP1 was established to produce standard curve which showed linearity between 0.1～60.0 ng/ml with a sensitivity of 0.1 ng/ml.Conclusion:These results show three hybridomas producing high specificity and affinity monoclonal antibodies against AFMP1 and can provide for rapid assay for the measurement of aspergillus fumigatus antigen.

Objective To investigate the carriage and homology of carbapenemase genes of multidrug-resistant Acinetobacterbaumannii (MDRAB)in Wujiang area.Methods A total of 44 non-duplicated MDRAB isolated from patients in 3 general hospitals in Wujiang area from January 2010 to December 2013 were collected. Minimum inhibitory concentrations (MICs)were detected,carbapenemase genes OXA-51,OXA-23,OXA-24,OXA-58, IMP,TEM,SHV,and GES were amplified with polymerase chain reaction(PCR),homology of strains was detec-ted with pulsed-field gel electrophoresis (PFGE).Results 44 MDRAB strains were mainly collected from sputum (93.18% ),mainly distributed in intensive care unit (ICU),department of respiratory diseases,and department of neurosurgery,accounting for 45.45% ,27.27% ,and 13.64% respectively;MDRAB were both sensitive to minocy-cline and polymyxin B,resistance rates to piperacillin,ampicillin/sulbactam,ceftazidime,gentamicin,amikacin, and ciprofloxacin were all 100.00% ,resistance rates to imipenem and meropenem were both 97.73% . 44 MDRAB strains were all detected OXA-51,OXA-23 and TEM genes,12 strains were positive for GES gene,1 strain was positive for OXA-58 and SHV respectively,OXA-24 and IMP genes were not found ;MDRAB were divided into 7 types of G-A,which included 19,3,9,3,1,4,and 5 strains respectively,type A was mainly from two large gen-eral hospitals in Wujiang area (Wujiang First People’s Hospital and Shengze Hospital),type B,D and E strains were not detected in Wujiang First People’s Hospital,type E strain was only 1 isolate and was from Yongding Hos-pital,the other types were sporadically distributed.Conclusion Multidrug resistance of clinically isolated Acineto-bacterbaumannii is serious in Wujiang area,OXA-23 and TEM genes are major causes of multidrug resistance in Acinetobacterbaumannii,the main types are A and C,which present clonal spread.

Objective To investigate the clinical value of echocardiography combined with genetic testing in the fetal cardiac rhabdomyoma. Methods Thirty-three fetal cardiac rhabdomyoma cases diagnosed by fetal echocardiogram in Beijing Anzhen Hospital from Jan. 2011 to Oct. 2015 were enrolled in a retrospective analysis. The results of other examination and pregnancy outcomes of them were followed up, the genetic characteristics of cardiac rhabdomyoma were summarized on the basis of pathology and genetics examination results. Results The pregnancy outcomes:24 cases were terminated pregnancy, 4 cases were born and 5 cases were lost. The results of ultrasound, pathology and genetic examination were detailed in 8 cases. Pathological examination: the typical characteristics of cardiac rhabdomyoma were found in the 8 cases with cardiac rhabdomyoma. The tumor tissue was composed of irregular and swelling shape of cardiomyocytes, and the cytoplasm was vacuole like, which was characteristic of“spider like cells”through microscopic observation. The geneticdetection results: 7 cases had tuberous sclerosis complex (TSC) gene mutation, TSC gene abnormalities were not detected in 1 case. Among the 7 cases with TSC gene mutations, 6 cases were with TSC2 gene mutation and the other 1 case was with TSC1 gene mutation. The family gene was investigated in the 5 cases, which including 3 cases of TSC gene mutation in mother passed on to the fetus (1 case with family of three generations of genetic) and 2 cases of spontaneous TSC gene mutation in the fetus. Conclusions Prenatal echocardiography combined with genetic detection have important clinical significance, which not only can clear if cardiac rhabdomyomas were associated with TSC, but also can clear the TSC gene mutation source. So as to further guide the perinatal management.

OBJECTIVE:To provide a reference for reducing adverse events due to off-label use of drugs and promoting ratio-nal use of intravenous drugs in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine. METHODS:The pre-scriptions of intravenous drugs in 42 wards of our hospital from Jul. 2013 to Jun. 2014 were reviewed,and then off-label use of drugs were analyzed,where statistics was made mainly to drug overdose,the use of drugs at the concentration beyond the standards (including concentrations too high and too low) and associated conditions. RESULTS:There were 622 irrational prescriptions,in-cluding 60 concerning off-label use of drugs,accounting for 9.6% of irrational prescriptions,in which 40 were involved with the concentration which was too high,accounting for the highest percentage(66.7% of prescriptions related to off-label use of drugs), 17 were related to drug overdose(28.3% thereof),and 3 were in relation to the concentration which was too low(5.0% thereof). CONCLUSIONS:Pharmacy intravenous admixture service may,through the communication between the pharmacist and the doc-tor,refuse to make up the above-mentioned prescription which was found to be irrational(including that involving in off-label use of drugs)or make up such prescription after it is modified according to the requirements as specified in the label to reduce the occur-rence of off-label use of drugs so as to promote rational drug use.

Objective To investigate the relationship between the genetic polymorphisms of glutathione S-Transferase M1,T1 and the susceptibility to sporadic colorectal adenocarcinoma(SCRAC) and smoking and alcohol consumption in Chinese Hans.Methods Multiplex polymerase chain reaction (M-PCR) was used in the study of genetic polymorphisms of GSTM 1,T1 gene.Logistic analysis was performed to elucidate the roles of GSTM1,GST1,smoking and alcohol.Results The null GSTM1,T1 genotypes could increase the susceptibility to SCRAC(OR=1.711,95% CI:1.043～2.805;OR=1.734,95% CI:1.057～2.843),but smoking and alcohol consumption made no significant effect on SCRAC(OR=0.584,95% CI:0.356～0.958;OR=0.378.95% CI:0.217～0.657).Further stratification of the SCRAC patients by chnical features showed that there were no relationship between the GST M1,T1 genotype and the age of the SCRAC patients.But the frequency of null GSTM1 genotype was significantly associated with distal colon adenocarcinoma (P=0.021),colorectal adenocarcinoma of Dukes C classification (P=0.003) and poor difierentiation (P=0.020),respectively.The frequency of null GSTF1 genotype was only higher in colorectal adenocarcinoma of Dukes C classification(P=0.041).No relationship was found between the location,the degree of differentiation and the frequency of null GSTF1 genotype(P＞0.05).Furthermore,the frequencies of homozygous deletion in GSTM1,T1 genes were found to be significantly increased in SCRAC patients than those in healthy controls(38.9%VS25.7%.P=0.023).Conclusion The GST genotype is strongly correlated with SCRAC incidence in Chinese Hans.The null GSTM1,T1 genotypes can enhance the genetic susceptibility to SCRAC.while smoking and alcohol consumption have no significant effect on the susceptibility to SCRAC.

Objective To investigate the effect of vitamin D supplementation on biochemical imdexes and compliations in patients with type 2 diabetes(T2DM).Methods Two hundred and ten patients with type 2 diabetes of the People's Hospital of Chongli County were selected from January 2001 to January 2002.According to the envelope sampling method they were divided into vitamin D supplementation group of 105 people and not supplemented group of 105 people,and 105 healthy people at the same period as control group.Compared the biochemical baseline indicators differences.After 10 years of follow-up,the biochemical indexes and the complications were detected and compared again.Results After ten years follow-up,82 cases of supplementation group were followed up,78 cases of not supplemented group were followed up.The level of FPG and HbA1c of supplementation group and not supplementation group were higher than that of control group,the differernce was significant(P＜0.05).In supplement group,TG levels,25(OH) D3 concentrations and BMD values were (2.11±0.41) mmol/L,(16.88±5.02) μg/L and-1.15±(-0.25) respectively,and equal to the control group ((2.12 ± 0.38) mmol/L,(44.83 ± 21.25) mmol/L,-0.94 ± (-0.21)),and TG levels were lower than not supplemented group,25 (OH) D3 concentrations and high bone density higher than not supplemented group((24.53±15.61) mmol/L,-3.15±(-0.33),P＜0.05).FPG,Cr,BUN,UA,FIB,and BNP in supplement group were(10.00±2.32) mmol/L,(64.77±9.31) μmol/L,(6.41± 1.24) mmol/L,(339.83±43.74) mmol/L,(2.41±0.46) g/L and (588.92±73.69) ng/L,in not supplemented group were (15.60±2.51) mmol/L,(92.69±11.68).μmol/L,(8.70±2.35) mmol/L,(398.94±49.13) mmol/L,(2.89±0.54) g/L and (761.09±91.52) ng/L,all higher than those in control group ((5.01 ±0.59) mmol/L,(57.81±6.61) μmol/L,(4.52±1.11) mmol/L,(311.83±49.51) mmol/L,(2.00±0.31) g/L,(434.31 ± ±71.03) ng/L),and those indexes in supplement group all higher than in not supplemented group(P＜0.05).The level of HbA1c of supplement group and not supplemented group both higher than control group((11.32 ± ±2.03) ％,(13.22±4.17) ％ and (5.34±1.99) ％,P＜0.05).There were 45 cases in supplement group occurred diabetic nephropathy and cardiovascular complications,and 65 cases of not supplemented group (x2 =15.07,P＜0.05).Conclusion The relationship of Vitamin D and various complications of diabetes mellitus are closely,and supplementing vitamin D can reduce the complications of diabetes.

Objective To explore drug resistance and distribution of multidrug-resistant(MDR)Mycobacterium tuberculosis (M.tuberculosis)in a county-level hospital,so as to strengthen the prevention and control of health-care-associated infection with M.tuberculosis .Methods Specimens with positive sputum smear were performed M. tuberculosis culture and drug resistance testing,and distribution of MDR tuberculosis patients in the departments before isolation were investigated retrospectively.Results Of 488 patients with tuberculosis,254 were positive for sputum smear,122 M.tuberculosis strains were isolated from positive sputum smear patients,120 isolates were per-formed drug susceptibility testing,results revealed that 86 isolates were drug-resistant strains,46 of which were monodrug-resistant,40 were MDR.Of MDR strains,16 were all resistant to isoniazide,rifampicin,streptomycin, and ethambutol.The percentage of monodrug-resistance,MDR,pandrug resistance was 9.43%,8.20%,and 3.28% respectively.Medical imaging department,ultrasound department,and respiratory disease department were the main units of M.tuberculosis exposure.Conclusion The percentage of MDR M.tuberculosis is high among M. tuberculosis ,surveillance should be intensified,so as to prevent the transmission in hospital.

Objective To study the protective effect of total glucosides of Mudan cortex(TGM) on acute myocardial ischemia in mice and its mechanism. Methods The total of 60 mice were randomly divided into 5 groups (n = 12),normal control and model control (were given equal capacity of 0.9% sodium chloride solution),and TGM at low,middle,high dose (were given with 50,100,200 mg?kg-1 TGM).The mice were administered once daily for consecutive seven days.After the last administration,the mice in the model control and drug groups were treated by intraperitoneal injection of 15 mg ? kg-1 isoproterenol to to make myocardial ischemia animal model. TGM on the T wave and J point on ECG, and serum lactate dehydrogenase (LDH),myocardial tissue superoxide dismutase (SOD),malondialdehyde (MDA) changes was detected,and the extent of myocardial ischemic injury in mice was measured by Nagar-Olsen staining. Results TGM significantly reduced the displacement of ECG T wave and J point,and improved the related biochemical indexes in mice with myocardial ischemia.The activity of LDH [(898.992± 285.108) μmol?mg-1 ] ,the content of MDA [(11.737 ±5.162) nmol?mg-1 ]in mice treated with TGM at high dose obviously decreased in comparison to the model controls,and the activity of myocardial SOD [(45. 505 ± 20.711) U?mg-1 ] significantly elevated compared with the model control.It was showed that TGM significantly diminished the areas of cardiac muscles ischemia injured via Nagar-Olsen staining. Conclusion TGM has the remarkable protective effect on acute myocardial ischemia injury in mice.