Objective To explore the clinical characteristics and treatment strategies in preterm premature rupture of membranes.Methods The clinical data of 730 cases with preterm premature rupture of membranes from January 2005 to December 2009 in our hospital were retrospectively analyzed.The characteristics and perinatal outcomes were summarized.Results The incidence rate of preterm premature rupture of membranes was 2.68 %.The relative factors developing preterm premature rupture of membranes were in turn infection,high tension of uterus and abnormal fetal position.The perinatal complications were mainly preterm,fetal distress and RDS.The perinatal outcomes were directly related to the gestational weeks.Conclusion According to the relative factors leading to preterm premature rupture of membranes,adopting the relative clinical treatment,strengthening the gestational health and comprehensive treatment may reduce the morbidity of maternal and newborn and improve the prognosis of preterm neonates.

砄bjectives:To observe the difference of programmed cell death (PCD) and the expression of related gene p 53 in the development of normal palate and in the formation of cleft palate.Methods:The model of the development of cleft palat was estabished with retinoid acid (80 mg?kg 1 for each pregnant mouse). The palate samples were obtained at GD13 14 (at 13rd day 14 hours of prenancy),13 22 ,14 8,14 14 ,14 33 ,15 8,15 22 and 16 8 respectively.PCD was detected with TUNEL staining,while the mRNA transcription of p 53 was observed by in situ hybridization.Rssults:In early development of palate process,the positive index of PCD in the cleft palate samples was significantly higher than that in the normal ( P 0.05) between the two groups.Conclusion:The proliferation of mesenchymal cells of the early developmental palate process may be inhibited due to the abnomal PCD in the formation of cleft palate.The mechanism of PCD in this study may be a p 53 independed pathway.

Objective To investigate the relationship between interaction of peroxisome proliferators-activated receptor alpha (PPARα), cytochrome P450 oxysterol 7α-hydroxylase (CYP7B1) and estrogen receptor (ER) and intrahepatic cholestasis in pregnant rats. Methods Eighty clean SD pregnant rats were selected and divided into four groups randomly with 20 in each. Since the 13th day of pregnancy,rats in the control group was injected subcutaneously with refined vegetable oil 2.0 ml · kg-1 · d -1 , those in the low-dose, moderate-dose and high-dose groups received 17-α-ethynylestradiol (EE) 1.0 mg · kg-1 · d-1,1.25 mg · kg-1 · d-1 and 1.5 mg · kg-1 · d-1, respectively. All rats were sacrificed at the 21at day of pregnancy and maternal hepatic tissues were collected. The serum levels of alanine aminotransferase(ALT), aspartate transaminase (AST), total bile acid (TBA) and bilirubin (BIL) were determined by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of PPARα, CYP7B1, Erα and Erβ in maternal rat livers were examined by real-time PCR. Results (1) Biochemical indicators: the serum levels of ALT,AST, TBA and BIL were significantly lower in the control group than in the rest 3 groups,respectively [ control group: (41.1 ± 2.8 ) U/L, (44.4 ± 3.6) U/L, (26.4 ± 5.6 ) μmol/L and( 2.8 ± 0.2)U/L;low-dose group: (48.2 ±3.4) U/L,(47.9 ±3.7) U/L,(36.4 ±4.2) μmol/L and (4.2 ±0.2) U/L;moderate-dose group: (70.4 ± 5.3 ) U/L, (68.4 ± 5.6) U/L, (64.3 ± 3.8 ) μmol/L and ( 6.2 ± 1.2)U/L; high-dose group: (72.4 ±7.6) U/L, (70.2 ±3.8) U/L, (72.4 ±7.8) μmol/L and (8.2 ±2.2)U/L, P<0.05], and those in the moderate or high-dose groups were higher than in the low-dose group (P<0.05). (2) mRNA expression of Erα and Erβ: the mRNA expression of Erα in pregnant rat livers increased in a dose-dependent manner, which were all significantly higher than that in the control group,respectively ( low-dose group: 0.76 ± 0.02 ); moderate -dose group: ( 0.99 ± 0.04; high-dose group:1.21 ±0.01 ;control group:0.65 ±0.01, P <0.05), but no difference was found among the 4 groups in the mRNA expression of Erβ ( P > 0.05 ). (3) mRNA expression of CYP7B1 and PPARα: the mRNA expression of CYP7B1 in pregnant rat livers increased from the low-dose group to the high-dose group, and were all higher than that of the control group ( low-dose group: 0.93 ± 0.01; moderate-dose group: 0.99 ±0.06; high-dose group: 1.22 ± 0.04; control group: 0.75 ± 0.02, P < 0.05 ). However, the mRNA expression of PPARα decreased from the low-dose group to the high-dose group, and were all lower than that of the control group (low-dose group: 0.83 ± 0.05; moderate-dose group: 0.71 ± 0.02; high-dose group:0.64 ± 0.03; control group: 1.35 ± 0. 05; P < 0.05 ) . Conclusions The down regulated mRNA expression of PPARα, caused by higher dose of estrogen, may increase the expression of CYP7B1 due to the ineffectiveness of the inhibition of PPARα on CYP7B1, which may further stimulate the Erα activity and then induce intrahepatic cholestasis. Abnormal expression of PPARα, CYP7B1 and ER may play a role in the pathogenesis of estrogen-induced intrahepatic cholestasis.

Objective:To observe the changes of visual evoked potential(VEP)in diabetic rats and the influence of nerve growth factor(NGF)and aminoguanidine(AG)on VEP.Methods:Diabetes was induced in adult male Wistar rats with streptozotocin(STZ).Rats were divided into normal control group(CON),diabetes model group(DM).NGF-treated group(D +N)and AG-treated group(D+A).VEP was measured during the 3~(rd)month,6~(th)month,9~(th)month,and 12~(th)month.Results: Compared with the CON group,all rest groups had longer latencies and lower amplitudes(P

Objective To investigate whether nimodipine could reduce complications after microvascular decompression in patients with hemifacial spasm. Methods 220 patients with hemifacial spasm , admitted into our hospital from May 2011 to Oct. 2013 , were all treated by microvascular decompression. They were divided randomly into two groups. Patients in the treatment group were treated with nimotop 50 mg/d after the operation for the first 3 days, then was orally taken 30 mg/d for a week. Patients in the control group were treated with the same after the operation without nimodipine. The postoperative complications including hearing deficit and peripheral facial paralysis were closely observed within three months after operation. Results The total effective rate was 100% in both groups. The incidence rate of peripheral facial paralysis and hearing deficit in treatment group was significant lower than that of the control group (P < 0.05). Conclusion Nimodipine has significant effect on reducing the incidence rate of peripheral facial paralysis and hearing deficit after microvascular decompression in patients with hemifacial spasm.

Objective To investigate association between postural changes of blood pressure and carotid atherosclerosis in the elderly.Methods Standardized questionnaires,physical examination and biochemical blood tests were performed to acquire clinical characteristics of the participants.Presences of carotid plaques were identified by carotid ultrasound examination.Orthostatic hypotension (OH) and orthostatic hypertension (OHT) were defined according to the international consensus.Multivariable logistic regression analysis was performed to analyze the associations of carotid plaques with OH and OHT.Results 377 old people were finally included,of which 101 had OH and 33 had OHT.After full adjustment for possible confounders,old people with carotid plaques had significantly increased risk for OH as compared with those without carotid plaques (OR=2.27,95％ CI:1.32-3.90,P=0.003).Participants with bilateral carotid plaques were associated with significantly increased risk for OH (OR=3.45,95％CI:1.74 6.84,P=0.001),while the association between unilateral carotid plaques and OH was not significant (OR=1.71,95％ CI:0.88-3.32,P=0.112).No significant association was identified between carotid plaques (bilateral or unilateral) and OHT.Conclusions Presence of carotid plaques,particularly bilateral plaques,may be an independent risk factor for OH.

Objective To determine the function of toxic protein VapC in toxin/antitoxin system of Leptospira species and the cytotoxicity to host cells of the toxic protein.Methods Using genomic DNA of pathogenic L.interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai as the template,several PCRs were performed to amplify entire vapB,vapC and vapBC genes.Subsequently,the prokaryotic expression systems of vapB,vapC and vapBC genes were constructed.Expression of the target recombinant proteins rVapB and rVapC was detected by SDS-PAGE and the expressed rVapB and rVapC were extracted by NiNTA affinity chromatography.Activity of rVapB and rVapC to lyse the DNAs or RNAs from L.interrogans strain Lai and THP-1 cells were then determined.The changes of transcription and expression of vapB and vapC genes of L.interrogans strain Lai before and after infection of THP-1 cells were detected by real-time fluorescent quantitative RT-PCR and Western blot assay.The eukaryotic expression vectors of the vapB and vapC genes were generated for transfection of host cells and CCK-8 agent was used to detect the effect of leptospiral VapB and VapC proteins on activity of host cells.Results The nucleotide and putative amino acid sequences of the cloned vapB and vapC genes were completely identical with the reported corresponding genes.The constructed prokaryotic expression systems could express rVapB and rVapC,respectively.rVapC displayed RNase avtivity but did not lyse DNA.When L.interrogans strain Lai infected THP-1 cells,the transcription and expression of vapB and vapC genes were upregulated and partial VapC protein was secreted from the leptospiral cells.The mass mortality was observed in HEK293 human renal tubular epithelial ceils containing the vapC gene through transfection.Conclusion VapC protein of L.interrogans strain Lai is a RNase and is secreted during infection of host cells with obvious cytotoxicity.

Objective To evaluate gray matter volume,white matter volume and FA value changes in amyatrophic lateral sclerosis(ALS)patients by voxel-based morphometry(VBM)and voxel-based diffusion tensor analysis(VBDTA).Methods Thirty-nine definite or probable ALS patients diagnosed by El Escorial standard and 39 healthy controls were recruited and underwent conventional MR scans and the neuropsychological evaluation.The 3D FSPGR T_1WI and DTI data were collected on GE Medical 3.0 T MRI system.The 3D T_1 structural images were normalized,segmented and smoothed,and then VBM analysis was performed.DTI data were acquired from 76 healthy controls,and FA map template was made.FA maps generated from the DTI data of ALS patients and healthy controls were normalized to the FA map template for voxel-based analysis.ANCOVA was applied,controlling with age and total intracranial volume for VBM and age for VBDTA.A statistical threshold of P＜0.01(uncorrected)and cluster level of more than continuous 20 voxels determined significance.Results Statistical results showed no significant difference in the global volumes of gray matter and white matter,total intracranial volumes and gray matter fraction between ALS patients and healthy controls,but the white matter fraction of ALS patients(0.29±0.02)was significantly less than that of healthy controls(0.30±0.02)statistically(P=0.003).There was significant reduction of gray matter volumes in bilateral superior frontal gyri and precentral gyri,right middle frontal gyrus,right middle and inferior temporal gyrus,left superior occipital gyms and cuneus and left insula in ALS patients when compared with healthy controls;and the regional reduction of white matter volumes in ALS patients mainly located in genu of corpus callosum,bilateral medial frontal gyri,paracentral lobule and insula,right superior and middle frontal gyrus and left postcentral gyrus.VBDTA showed decrease in FA values in bilateral parahipocampal gyri and cingulate gyri in ALS patients compared with healthy controls.Conclusions VBM and VBDTA analysis results suggest that ALS is not simply a motor neuron disease but a multisystem disorder;and VBDTA has a potential value for the detection of FA value changes of cingulate and parahippocampal gyral white matter in suspected cognitive impairment of ALS patients.

ObjectiveTo explore the best measurement of waist circumference related with intra-abdominal fat volume evaluated by CT scan.MethodsHeight,weight,and hip circumference were measured among 147 subjects aged over 18 years old.Waist circumference was measured at 3 different levels:the upper brim of the iliac crest ( WC1 ),the midpoint between costal brim and iliac crest ( WC2 ),and the umbilicus ( WC3 ).The intra-abdominal fat volume was evaluated by CT scan.ResultsIntra-abdominal fat volume was significantly higher in men than in women [ ( 1 236.0±608.4 vs 931.0±665.0)cm3,P＜0.01 ].Correlation analysis showed that WC1 ( r =0.634),WC2( r=0.677),and WC3 (r =0.712)were positively correlated with intra-abdominal fat volume ( all P＜0.01 ).Partial correlation analysis adjusted by gender,weight,or body mass index showed that the correlation of intra-abdominal fat volume with WC3 ( r were 0.488 and 0.432) was better than that with WC1( r were 0.347 and 0.293 ) and WC2 ( r were 0.424 and 0.365 ).Multiple linear stepwise regression analysis demonstrated that WC2 and WC3 were independently associated with intra-abdominal fat volume and WC3 was the strongest impact factor (β =0.270,R2c =0.504,P＜0.01 ).ConclusionsWaist circumference is a simple anthropometric measurement parameter reflecting the degree of intraabdominal fat accumulation.All three different measurements of waist circumference may reflect intra-abdominal fat volume,while waist circumference at umbilical level is the best among them.

BACKGROUND: The biological functions of platelet-rich plasma (PRP) are affected by multiple factors, such as individual difference, PRP concentration, PRP carder, PRP-activated methods and so on. OBJECTIVE: To evaluate the effect of PRP, activated by different concentrations of thrombin, on the repair of cranial defects. METHODS: Whole blood of the central artery of rabbit ears was extracted to prepare PRP, which was then diluted so that the final platetet count was about 5 times of the whole blood. Four whole-thickness layer of cranial defects at an 8-mm diameter were created in 16 New Zealand rabbits and randomly grafted with β-tdcalcium phosphate (β-TCP) and PRP, activated by 60 U/mL. thrombin; β-TCP and PRP, activated by 1 000 U/mL thrombin; β-TCP and PRP; β-TCP alone. At 1 and 3 months following implantation, X-ray analysis and microscopic observation were performed to onserve cranial repair, the area percent of new bone formation was calculated. RESULTS AND CONCLUSION: At one month post-surgery, the edge of defects was clear in each group, with varying degrees of new bone formation surrounding the defects, β-TCP particles partially degraded and the degradation lesion was replaced by new bone, only a small amount of bone lacunae was seen, fiber wrapped around the defect center β-TCP, only a small number of specimens showed new bone formation; X-ray showed a clear boundary and uniform defect density; the percentage of new bone formation in the PRP groups were higher than β-TCP groups (P < 0.05). However, there was no significant difference between PRP group groups (P > 0.05). At 3 months post-surgery, the defect boundary was unclear in each group, the new bone formation increased, the β-TCP particles surrounding defects partially or all degraded and were replaced by new bones, some regions appeared trabecular bone, bone lacuna in new bone was increased, the central defect of the majority of specimens exhibited new bone formation; X-ray showed defect boundary was unclear in each group, defect surrounding density was higher than the center defect, and bone mineral density was equivalent to other normal parts; the percentage of new bone formation in the PRP groups was significantly higher than that in the β-TCP groups (P < 0.05), PRP +β-TCP group was higher than the other 3 groups (P <0.05), there was no significant difference between two thrombin groups (P > 0.05). It is indicated that although PRP improves the repair of cranial defects, 60 and 1 000 U/mL of thrombin has no effects on PRP rapairing cranial defects in New Zealand white rabbits, compared with PRP+β-TCP group, possible the absence of the optimal concentration of thrombin.