ObjectiveTo investigate the clinical features and pregnant outcomes of the pregnant women with congenital adrenal hyperplasia (CAH) 21-hydroxylase deficiency (21-OHD).MethodsThe clinical features,therapies,pregnant outcomes of the pregnant women with 21-OHD were retrospectively reviewed in Peking Union Medical College Hospital,from January 2005 to April 2011.ResultsThere were 8 pregnant womenwith 21-OHD including 5siinplevirilizing patientsand 3nonclassical 21-OHD women.Eightpatientswereacceptedprogestationalandprenatalcontinuallowerglucocorticoid treatment.During the gestational period,the dosage of glucocorticoid was adjusted in one pregnancy.The serum level of 17-alpha hydroxyprogesterone (17-OHP) were elevated after pregnancy [ (70 ± 38 ) versus (24 ±23) nmol/L,P ＜ 0.05].The fertility and offspring rate of 8 patients was 8/12,the fertility and offspring rate of patients who started treatment at preadolescence was significantly increased (4/5 versus 4/7).Four patients were accepted genital reconstructive surgery ( clitorectomy,clitoroplasty,vulvoplasty) before pregnancy.The incidence of GDM was 1/8.All patients selected caesarean at from 37 +6 gestation weeks to 39+6 gestation weeks.The average newborn birth weight was (3210 ± 447 ) g,and height was (48 ±2) cm of 8 neonates,none of them was CAH.Conclusions Medical and surgical therapy provides satisfactory fertility and pregnancy outcomes for women with 21-OHD.It is safe to pregnant women with 21-OHD and their fetus in continual lower glucocorticoid treatment.The dosage of glucocorticoid should be carefully adjusted during the pregnancy individually according to serum level of 17-OHP.

Objective To study the effects of Poly(I:C) on lung adenocarcinoma A549 cells viability and illuminate the mechanism of Poly (I:C)-induced apoptosis in A549 cells.Methods A549 cells were transfected with the complex of Poly(I:C) and lipofectamine 3000.The viability of A549 cells was tested by methyl thiazolyl tetrazolium (MTF) method.The apoptotic cells were tested by flow cytometry.The caspase proteins were tested by Western blotting and the expressions of interferon-β (IFN-β) and CXCL-10 were assayed by real-time PCR.After employing the pan-caspase inhibitor Z-VAD-FMK and caspase-8 inhibitor Z-IETD-FMK,the variation of Poly (I:C) proapoptosis in A549 cells was observed.RNA interfering experiments were employed to knock down melanoma differentiation related antigen 5 (MDA5) or retinoic acidinduced gene Ⅰ (RIG-Ⅰ),and the above indexes were tested.Results The viability of A549 cells was significantly reduced to 74.92％ ±--6.24％ after 200 ng/ml Poly (I:C) transfection compared with that before transfection (95.32％ ± 3.05％,t =2.883,P =0.041).The apoptotic rates induced by 100,200,400 ng/ml Poly(I:C) were 9.97％-± 0.88％,23.63％-± 1.41％,32.57％-± 2.39％,respectively.All of them were higher than that in the control group (0.74％-± 0.15％),with significant differences (t =4.489,P =0.002;t =11.616,P =0.000;t =16.932,P =0.000).Besides,the death receptor pathway proteins such as TNF-related apoptosis inducing ligand (TRAIL),cleaved-caspase-8 and cleaved-caspase-3 increased obviously.MDA5/RIG-Ⅰ pathway was also activated dramatically and the expressions of IFN-β,CXCL-10 were significantly up-regulated.The apoptotic rates reduced to 3.17％ ± 0.66％,5.35％ ± 0.64％ with pancaspase inhibitor Z-VAD-FMK and caspase-8 inhibitor Z-IETD-FMK pretreatment,compared with the control group (15.87％ ±0.93％),and the differences were statistically significant (t =8.643,P =0.001;t =6.824,P =0.002).Moreover,the expressions of TRAIL,IFN-β and CXCL-10 induced by Poly (I:C) were inhibited with MDA5 or RIG-Ⅰ depletion.Conclusion Poly(I:C) can reduce the survival rate of A549 cells and promote the apoptosis mainly by activating the death-receptor pathway mediated by MDA5/RIG-Ⅰ probably,which may involve in IFN-β,CXCL-10.

Objective To investigate the prognostic significance of proteolysis-inducing factor (PIF) in gastric cancer patients.Methods Biopsies of the rectus abdominis muscle were obtained intra operatively from 53 gastric cancer patients and 53 subjects undergoing surgery for benign abdominal diseases,muscle and serum PIF,ubiquitin expression,and proteasome proteolytic activities were assessed through reverse-transcription polymerase chain reaction (RT-PCR),Western blot,and enzyme-linked immunosorbent assay (ELISA).Results PIF was significantly upregulated in muscle of gastric cancer compared to control muscles.PIF was upregulated in 60％ (32/53) muscle of gastric cancer.Over expression of PIF in muscles of gastric cancer were associated with level of serum albumin,tumor node metastasis (TNM) stage,and percent of weight loss.The survival rate of patients with a high expression of PIF was significantly lower than those in patients with low expression (P ＜ 0.05).Conclusions PIF was significantly upregulated in muscle of gastric cancer,over expression of PIF in muscles of gastric cancer was associated with level of serum albumin,TNM stage,percent of weight loss,and prognosis.PIF might play an important role in progression and prognosis of gastric cancer.

Humans ; Hypertension ; Large-Conductance Calcium-Activated Potassium Channels

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.

Objectives To compare endovascular aortic repair (EVR) and medical therapy for acute type B aortic dissection (AD) in terms of treatment results.Methods From January 2004 to October 2010 116 cases were collected and were divided into two groups,with treatment of EVR (n =60)and medical therapy (n ＝ 56).Treatment outcomes were assessed.Results Clinical manifestations of AD are complex and variable,with the most common symptom being pain on chest and back (74.1％).CTA is the most valuable method in confirming the diagnosis of aortic dissection.In conservative group of 56 patients admitted to hospital,30-day mortality rate was 16.1％.In EVR group of 60 patients with grafts successfully released,the 30-day mortality was 1.7％.There is significant difference between the two groups on mortality rate during 30-day(P ＜0.05).Follow-up rate in conservative group and the EVR group was 71.4％ and 86.7％,with average follow-up time of (38 ± 16) months and (35 ± 14) months.The 5-year survival rates were 87.5％ and 88.5％ respectively in conservative group and EVR group (P ＞ 0.05).Conclusions EVR is considered to be the first choice for acute Stanford type B dissection.EVR can improve patients' 30-day survival,though long term result is comparable with that of conservative treatment.

BACKGROUND:Whether lumbar spondylolisthesis needs to be treated with reduction remains controversial.OBJECTIVE:To investigate the clinical effectiveness of pedicle screw fixation combined with posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis in the patients aged more than 70 years old.METHODS:The clinical data of 30 patients with degenerative spondylolisthesis aged over 70 years old undergoing pedicle screw fixation combined with posterior lumbar interbody fusion were analyzed retrospectively.The Visual Analogue Scale,Oswestry Dysfunction Index and the Japan Orthopedics Association scores were compared and analyzed before and after surgery.RESULTS AND CONCLUSION:(1) Among 30 patients,12 were male and 18 female,the average age was (75.1±6.7) years old,and all were followed up for more than 12 months.(2) The postoperative Visual Analogue Scale,Oswestry Dysfunction Index and the Japan Orthopedics Association scores were significantly improved compared with baseline (P ＜ 0.05).According to the Japan Orthopedics Association scores,3 cases were cured,24 were significantly effective,and 3 effective.(3) Graft fusion was achieved at all patients,the average fusion time was (5.13±0.65) months.(4) The average operation time was (225.6±23.4) minutes,the average intraoperative blood loss was (470±45.5) mL,and the average follow-up time was (25.8±3.5) months.(5) Six patients presented complications (20％),including one case of dural tear,two cases of paralytic intestinal obstruction,and three transient lower extremity nerve symptoms.(6) These results indicate that if the associated disorders are strictly controlled,pedicle screw fixation combined with posterior lumbar interbody fusion can achieve good surgical results in the treatment of degenerative spondylolisthesis in the elderly.

Objective To study the effect of field long march comprehensive training on freshmen' mental quality and mental health in military university. Methods Mental quality questionnaire for army men (MQQA), symptom checklist 90 (SCL-90), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and trait anxiety inventory (TAI) were carried out on 330 freshmen at various stages on their military training. All data were analyzed by paired-sample t test. Results ①As compared with pre-training, all SCL-90 factor scores except depression factor decreased significantly (P<0.05); compared to barracks military training, recruits revealed a decrease (P<0.05) in all SCL-90 factors except factors on fear, paranoia and mental disorder. ②The scores of SDS and SAS displayed a“V”shape as they decreased after the early rise at the course of military training. After the barracks military training, SAS and SDS scored high (P<0.01);Compared with pre-training, TAI scores dropped significantly (P<0.01) after field long march; compared with post barracks military traning results, SAS, SDS and TAI scores of recruits after field long march decreased significantly (P<0.05). ③After barracks military training and field long march comprehensive training, recuits' mental quality factors scored no significant distinction (P>0.05). Conclusion Filed long march effectively improved mental health of military university recruits and relived their anxiety as well as depression.

Objective To explore the clinic value of the vocal acoustics on voice evaluation in larynx leukoplakia pa?tients. Methods Dr. Speech software was used to perform voice acoustic analysis and deduce EGG parameters in 48 sub?jects with larynx leukoplakia and 50 normal subjects. Voice acoustic analysis parameters (Jitter, Shimmer, NNE, HNR, SNR, MPT), EGG parameters ( EGG-Jitter、EGG-Shimmer、EGG-NNE、EGG-HNR、EGG-SNR, CQP,CIP) and EGG wave?form were compared between two groups. Results For voice acoustic analysis, Jitter, Shimmer, NNE in larynx leukoplakia group were higher than those in normal group while HNR, SNR in larynx leukoplakia group were lower than those of normal group. What’s more,MPT in larynx leukoplakia group was obviously shorter than that in normal group with, statistically sig?nificant difference (P<0.05). For EGG analysis, EGG-Jitter, EGG-Shimmer, EGG-NNE were higher in larynx leukoplakia group than those in normal group with significant difference (P<0.05). EGG-HNR and EGG-SNR in larynx leukoplakia group were lower than those in normal group. Furthermore, CQP and CIP in larynx leukoplakia group were higher than those normal group with statistically significant difference (P<0.05). Most patients’(72.9%) EGG waveform showed gradually ac?celerate phase velocity and fast close phase, which represent a spike-like shape. Conclusion Voice acoustic analysis com?bined with EGG provide objective indicators to assess degree of hoarseness, and to provide sonic evidences for prevention, recurrence, assessment and pronunciation correction of the larynx leukoplakia.

Objective To explore the feasibility of human lung canccr cells grown in a decellularized rat lung matrix by perfusion.Methods Lungs were harvested from adult SD rats.Native cells of rat lungs were removed using 0.1％ sodium dodecyl sulfate (SDS) and 1％ Triton X-100 by perfusion to create a decellularized rat lung matrix.After decellularization,Human lung cancer H460 cells were implauted into the decellularized rat lung matrix and grown in a customized bioreactor with perfusion of oxygenated media for 1-2 weeks.Results Decellularized rat lung matrix showed preservation of matrix architecture devoid of all rat cells.H460 cells could grow in the bioreactor.Conclusions Human lung cancer H460 cells can grow in a customized bioreactor on a decellularized rat lung matrix.This ex vivo model can be used potentially to gain a deeper understanding of the biologic processes involved in human lung cancer.