The clinical data of 8 patients with the fourth-degree laceration of perineum, who were admitted in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2004 to December 2010, were reviewed retrospectively. The causes and clinical strategies were analyzed. The fourth-degree laceration of perineum was mainly caused by improper skills of midwifery, too faster labor,insufficient estimation of fetal-weight and perineal condition and obstetric forceps in this group of patients.Primary suture was performed and all cases achieved complete healing. The improvement of midwifery skill,carefully monitoring the uterine contraction, accurate evaluation of condition of perineum and the fetal-weight and good communication between patients and midwives are the key points to prevent the fourth-degree laceration of perineum.

·AIM: Impairment of choroidal perfusion was found in AMD patients. We postulated that vasoactive agents,which can reduce choroidal blood flow resistance, might prevent the development of choroidal neovascularization (CNV). D-Timolol and L-Timolol are hypotensive agents used in cardiovascular and glaucoma therapy. Their effects on laser-induced experimental CNV rat model and human umbilical vein endothelial cells (HUVEC) were thus evaluated.·METHODS: Male Brown Norway rats were anesthetized to receive Nd:YAG laser to break the Bruch's membrane. D-Timolol and L-Timolol were given once daily through intraperitoneal injection after laser treatment for 4wk. Fluorescein angiography was performed on 2wk and 4wk. HUVEC were tested by proliferation assay and adhesion assay with D-Timolol and L-Timolol at different concentrations.· RESULTS: D-Timolol reduced the fluorescein leakage to 83% of the control group in laser-induced rat's CNV model at a dosage of 15mg/(kg·d). L-Timolol had no effect on CNV formation even at a higher dosage of 20mg/(kg·d). D-Timolol inhibited the endothelial cells proliferation significantly by 300mg/L. L-Timolol also significantly inhibited the cell proliferation at 1 000mg/L. But at a lower dose such as 300mg/L, no significant inhibitory effect was found. Both drugs showed no effect on cell adhesion function in cell culture experiments.· CONCLUSION: D-Timolol was found to prevent CNV development in laser-induced model in vivo and inhibit vascular endothelial cells proliferation in vitro. L-Timolol had no effect on cell proliferation at the same dose, and neither on rat CNV model. The results indicate these two isomers have different functions on rat's CNV prevention and on HUVEC cell proliferation.

Caveolae are specialized lipid rafts that form flask-shaped invaginations of the plasma membrane. Many researches show that caveolae are involved in cell signaling and transport. Caveolin-1 is the major coat protein essential for the formation of caveolae. Recently, several reports indicated that the other caveolae-associated proteins, Cavins, are required for caveola formation and organization. It's worth noting that Cavin-1 could cooperate with Caveolin-1 to accommodate the structural integrity and function of caveolae. Here, we reviewed that the relationship between Cavins and Caveolins and explore the role of them in regulating caveolae.
Animals ; Caveolae ; physiology ; Caveolin 1 ; metabolism ; physiology ; Caveolins ; metabolism ; physiology ; Humans ; Membrane Proteins ; metabolism ; physiology ; RNA-Binding Proteins ; metabolism ; physiology

Objective To investigate the metabolic differences of Tacrolimus in different transplant recipients. Methods A retrospective study was conducted, 30 patients of the organ transplant admitted to organ transplantation center of General Hospital of Chinese People's Armed Police Forces from January 2002 to August 2012 were enrolled, and they were divided into combined liver and kidney transplant (SLK) group, single liver transplant group and single renal transplant group, 10 cases in each group. The SLK group and the simple liver transplantation group were given the same drug regimen, methylprednisolone injection was given during operation, and tacrolimus+ mycophenolate mofetil+ prednisone triple immunosuppressive therapy was taken after operation, on the first day after operation, the initial dose of tacrolimus was given 0.06 mg·kg-1·d-1 divided into 2 times taken orally, and on the third day after operation, the concentration of tacrolimus was detected; after operation group for 2 - 4 days, single renal transplantation group was given tacrolimus the initial dose of tacrolimus 0.15 mg·kg-1·d-1 was divided into 2 parts for twice oral administration, after 2 - 3 days of the above treatment, monitoring the concentration of tacrolimus began. One month after transplantation, the metabolic differences of tacrolimus among the three groups were compared.Results One month after operation, the oral tacrolimus doses (μg·kg-1·d-1: 74.78±32.65 vs. 80.62±24.02, 85.58±16.78) and the monitored blood drug concentration (μg/L: 6.64±2.73 vs. 7.50±3.08, 7.46±3.20) in SLK group were lower than either the single liver transplantation group or single renal transplantation group, but the comparisons among the three groups, there were no statistically significant differences(allP > 0.05).Conclusions In SLK group, the protective effect of transplanted liver on transplanted kidney may be related to the length of postoperative time. Liver transplantation performed within post-operative one month has no protective effect on the transplanted kidney.

Objective To investigate the risk factors of insulin resistance(IR)and its relationship with metabolic syndrome in patients after lenal transplantation.Methods 133 renal transplant redpients who had not undergone acute rejection,calcinurine intoxication and severe infection,and had normal renal function and no proteinuria at the 6th month post-transplantation,were involved in the study.They had a history of chronic glomerulonephritis as the primary disease of ESRF but rio diabetes mellitus.108 recipients(CsA group)were treated with CsA,mycophenolate mofetil(MMF)and prednisone after transplantation,19 recipients(Tac group)with tacrolimns(Tac),MMF and prednimne,and 6 recipients with Simlimus,respectively.One year later,blood and urine biochemical tests and physical examinations were performed on the recipients,and HOMA calculated.200 cormnunity residents were randomly selected as controls.Results The incidence of MS in the recipients was 33.1%,significantly higher than controls(15.0%).There was no significant difference in the incidence of obesity and overweight between recipients(29.3%)and controls(37.5%).In recipients with obesity or overweight,the insulin-resistance level and urine albumin level,and the incidence of MS weree significantly higher than those without obesity or overweight.The insulin-resistance level in Tac-treated recipients was markedly higher than CsA-treated recipients,and there was a positive correlation between the blood concentration of Tac and insulin-resistance levd.Microalbuminufia-positive recipients had higher insulin-resistance levels.Metabolic syndrome-complicating recipients had higher insulin-resistance levels than those without metabolic synawme,and higher insulinresistance levels existed in recipients with hypertriglyceridemia or hyperchcllesterolemia,hypertension.Conclusion Obesity or overweight,Tac(especially when blood concentration was higher)were risk factors resulting in imulin-resistanee in kidney transplant recipients.It is suggested that insulin-resistance might be involved in the pathogenesis of metabolic syndrome including hypertrglyceridmaia,hypercbolestemlemia and hypertenion.

Objective To explore effect of endogeneous gangliosides(Gls) and integrin ?2?1 on protein phosphotyrosine expression of pp125 focal adhesion kinase (pp125FAK) after adhesion of SK-N-SH neuroblastoma cells to collagen(Col).Methods SK-N-SH cell line with high expression of integrin ?2?1 was cultured in presence of D-threo-1-phenyl-2-decanolamino-3-morphinoline-1-propanol(D-PDMP).Effect of endogeneous Gls,anti-?2 and anti-?1 monoclonal antibody on protein phosphotyrosine expression of pp125FAK during adhesion of SK-N-SH cells to Col were determined by immunoprecipitate and Western blotting.Results After 6 days,endogenous Gls in cells were almost depleted.Gls-depletion,anti?2 and anti-?1 monoclonal antibody were able to decrease pp125FAK expression of SK-N-SH cells adherent to Col respectively.GD2,the major component of neuroblastoma cell Gls could reco-ver pp125FAK expression to a certain degree.Conclusions Endogenous tumor Gls regulate protein phosphotyrosine expression of pp125FAK during adhesion of neuroblastoma cells to Col.It is suggested that tumor Gls may increase signal transduction of tumor cell integrin ?2?1 by increasing tyrosine phosphorylation of pp125FAK.

Objective To investigate the effects of extended nursing based on relationship, information and management on the self-care behaviors of patients with heart valve replacement. Methods According to admission time, 37 patients with heart valve replacement were set as the control group, which was given routine nursing intervention and another 42 patients as the study group, which received extended nursing based on the trinity of relationship, information and management 2~8 weeks after discharge. Before and after intervention, patients were evaluated by using the improved version of self-care behavior evaluation scale of heart disease (SNBAOHD). Result There were significant differences between the two groups in other items of SNBAOHD, except two items of low salt diet and medication (P<0.05). Conclusions Extended nursing after discharge based on the trinity of relationship, information and management can help the patients to be continuously cared. In this case, it is effective for the enhancement of off-hospital self-care ability and prevention of disease relapses.

Objectives To investigate the delivery mode and perinatal outcomes of low birth weight infants in mainland China, and to explore the appropriate delivery mode and timing of delivery. Methods Clinical data of 103 678 babies delivered from Jan 1st to Dec 31th, 2011 in 39 hospitals in mainland China were analyzed retrospectively. The 39 hospitals located in 7 administrative regions, including Northeast, Northwest, North, Central, East, South and Southwest China. Result (1) The average birth weight of the newborns was (3 263 ± 540) g. Among them, 7 474 cases were diagnosed low birth weight infants, with the incidence of 7.209%(7 474/103 678). There were 2.328%(2 214/95 116 ) full-term low birth weight infants and 61.434% (5 260/8 562 ) preterm low birth weight infants. (2) From week 28 to week 36, the cesarean section rate of low birth weight infants increased with the increasing of gestational weeks. The cesarean section rate of full-term low birth weight infants were 61.14%(1 139/1 863) , which was higher than that of normal birth weight infants (52.947%, 45 108/85 195). The differences were statistically significant (P<0.01). (3) The constitution of the indication of cesarean section showed that social factor and maternal factor were 10.73%(443/4 128) and 48.91%(2 019/4 128) for low birth weight infants, respectively. While for the normal birth weight infants, they were 27.70%(12 495/45 108) and 38.60%(17 412/45 108), respectively. There was statistically significant difference(P<0.01). (4) The emergency cesarean section rate of full-term low birth weight infants was 41.09%(468/1 139), which was higher than that of normal birth weight infants (31.09%, 14 024/45 108). The difference was statistically significant (P<0.01). (5) The rates of stillbirth, neonatal asphyxia and the mortality of full-term low birth weight infants were 2.36%(44/1 863), 6.12%(114/1 863), and 3.17%(59/1 863), respectively. Those of normal birth weight infants were 0.11%(94/85 195), 1.41%(1 201/85 195), and 0.14%(119/85 195), respectively. The differences were statistically significant (P<0.01). (6) The stillbirth rate and mortality of low birth weight infants born by cesarean delivery were significantly lower than those born by vaginal delivery. The rate of neonatal asphyxia (17.95%) and other morbidity (3.61%) among low birth weight infants born by cesarean section in week 28 to week 33+6 were significantly lower than those born by vaginal delivery (30.09%, 6.62%, respectively). (7) With the increase of gestational age, the incidence of neonatal asphyxia and stillbirth decreased. The incidence of neonatal asphyxia(39.22%) and stillbirth(23.28%) was most seen in 28 to 29 gestational weeks, which decreased to 9.08% and 2.88% in 34 gestation weeks. Conclusions Low birth weight is one of the leading causes of adverse perinatal outcomes and cesarean section. To decrease the incidence of low birth weight, individualized management should be performed according to the gestational age and fetal condition. Extending the gestational age to at least 34 weeks may avoid iatrogenic preterm labor and improve the neonatal survival rate.

Objective To investigate the influencing factors of low birth weight infants (LBWI) in China in order to provide evidence for lowering the incidence of LBWI and improving the perinatal outcomes.Methods Clinical data were obtained from 14 different provinces, municipalities or autonomous regions in Northeastern, Northwestern, Northern, Central, Eastern, Southern and Southwestern of China, covering 39 hospitals of different levels.A total of 112 441 newborns were collected from January 1 to December 31 in 2011.After exclusion of those cases with incomplete information, miscarriage before 28 weeks of gestation, induction due to fetal malformation or intrauterine fetal death, 103 678 cases were restrospectively analyzed.Questionnaires were filled out and all data were recorded in computer network databases.Clinical data included maternal age, education background, height, weight, parity, histories of abnormal pregancy and comorbidities and complication.Independent sample t-test, Chi-square test, unvariate and ultivariate unconditional Logistics regression analysis were performed.Results The incidence of LBWI in mainland China was 7.21％ (7 474/103 678), 61.43％ (5 260/8 562) for preterm babies, and 2.33％ (2 214/95 116) for full-term babies.Univariate analysis showed that LBWI were associated with maternal age, education background, height, pregestational body mass index (BMI), weight gain during pregnancy, cord length, smoking, parity, histories of abnormal pregancy, gestational diabetes mellitus (GDM), preterm birth, hypertensive disorders in pregnancy, anemia, premature rupture of membranes and abnormal amniotic fluid volume.The following unconditional binary logistic regression analysis for those factors with P ＜ 0.3 in unvariate analysis showed that preterm birth (OR=46.246, 95％CI: 41.484-51.555), hypertensive disorders during pregnancy (OR=5.031, 95％CI: 4.325-5.853), histories of intrauterine fetal death ≥ 1 times (OR=2.446, 95％CI: 1.479-4.044), oligohydramnios (OR=2.068, 95％CI:1.659-2.578), pregestational BMI ＜ 18.5 (OR=1.637, 95％CI: 1.415-1.893), spontaneous abortion ≥ 1 times (OR=1.362, 95％CI: 1.043-1.777), age ≤ 20 (OR=1.332, 95％CI: 1.046 1.695), anemia (OR=1.230, 95％CI: 1.017-1.488) and premature rupture of membranes (OR=1.154, 95％CI:1.016-1.311) were risk factors for LBWI.The higher the maternal education level, weight gain, BMI and height, the lower the LBWI incidence.The risk factors of LBWI in premature small for gestational age (SGA) infants were hypertensive disorders during pregnancy and histories of intrauterine fetal death ≥ 1 times.The higher the maternal height and weight gain during pregnancy, the lower the incidence of LBWI in premature SGA infants.Conclusions The main influencing factors for LBWI are preterm birth and hypertensive disorders during pregnancy.In addition, LBWI is also associated with socioeconomic and genetic factors.

Objective To investigate the value of strain rate imaging(SRI) in estimating the changes of left ventricular regional myocardial function in patients with coronary artery disease before and after coronary artery bypass grafting operation. Methods In sixteen patients with coronary artery disease, echoeardiography was performed 3 days before, 12 days after and 3 months after coronary artery bypass grafting operation respectively. SRI was used to quantitatively analyze the regional myocardial function of left ventricular wall. One hundred and ninety-two segments of left ventricular myocardium were analyzed in the study. The left ventricular myocardium was divided into segments with normal(152 segments) and abnormal(40 segments) wall motion according to two-dimensional echocardiography before the operation. Results Peak strain rate during systolic and early diastolic contraction (SRs, SRe) was not statistically significant between segments with normal and abnormal wall motion before operation. In segments with abnormal wall motion,myocardial peak strain rate of atrial contraction (SRa) was increased three months after operation comparing with three days before operation (P<0.05). In segments with normal wall motion,the absolute values of SRs,SRa and SRe were increased three months after operation comparing with three days before operation (P<0.05 and 0.01 ). SRs was increased three months after operation comparing with 12 days after operation (P<0.05 ). Conclusions SRI can be used to evaluate the functional changes of left ventricular regional myocardium quantitatively after coronary artery bypass grafting operation.