Objective To investigate the effects of treatment of syphilis in pregnancy on perinatal prognosis. Methods Patients of syphilis in pregnancy from Hainan Provincial People′s Hospital and Haikou Municipal Maternal and Child Health Center during 1995.1 to 2001.1 were collected for retrospective analysis. Pregnant women with syphilis were divided into treated group and untreated group according to whether they received penicillin anti syphilis treatment or not during pregnancy. Results The total number of deliveries in the 2 hospitals during that period was 18 701, and 61 out of 9 805 women screened for syphilis were positive, giving an incidence of 6 2/1000. The perinatal mortality rates were 11 2% in treated group and 83 3% in untreated group, and incidences of congenital syphilis were 17 6% and 72 7% respectively. Conclusion Syphilis in pregnancy is a serious complication to harm the fetus. Screening of syphilis during pregnancy is necessary, and penicillin treatment is effective which may reduce the perinatal mortality rate and the birth of congenital syphilis baby.

A homozygous A to G transition (AGT to GGT) in codon 16 of growth hormone receptor (GHR) gene was found in one patient with idiopathic short stature(ISS), resulting in an amino acid change(Ser16Gly). This may be a novel GHR gene mutation; and another novel Arg43Gln GHR gene polymorphism was found in Chinese people.

Objective To detect and determine the expression and significance of MHC class Ⅰ chain-related gene A/B (MICA/B) and membrane MIC molecules (mMIC) on the bone marrow mononuclear cells (MNC) of patients with acute leukemia (AL). Methods Expression of MICA/B gene was detected by semi-quantitative reverse transcriptaso polymerase chain reaction (RT-PCR) in MIC-pesitive K562 cell line, bone marrow MNC from 10 healthy people and 69 cases of acute leukemia (AL). Expression of mMIC was detected by Western blotting. The differences of the expression of MIC gene and mMIC between AML and ALL were compared. The prognosis was determined by chromosome type between patients with mMIC+ and mMIC-. Results The expression of MIC gene and mMIC could not be detected in healthy people. The expression rate of MICA gene was 49.28% and the MICB gene was 42.03% and the mMIC was 34.78% in patients with AL. In AML group, the expression rate of MICA gene was 60.00%, and the expression rate of MICB gene was 53.33%, and the expression rate of mMIC was 44.44%. But in ALL group, the expression rate of MICA gene was 29.17%, of MICB gene 20.83%, and of mMIC 16.67%. The expression of MICA/B gene and mMIC in AML group were higher than that in ALL group (P<0.05). The prognosis of patients with mMIC+ is better than the ones with mMIC-. Conclusion The up-regnlation of MIC gene and mMIC in bone marrow MNC from patients of AL may have some relationship with the occurrence of AL The expression of MIC gene and mMIC is high in AML and low or devoid in ALL, which would be an possible mechanism that ALL cells were easy to escape killing from NK and CTL cells. Determined by chromosome type, the prognosis of AL with mMIC positive was better than the ones with mMIC negative. MIC might be one of the factors to determine the prognosis of AL.

The scientific after-class activities in pediatrics can increase the synthetic ability of the medical students,including the manners of occupation,professional level,the skill of communication,clinical practice,serving community,the management of information and the critical thinking.

Objective To explore a preliminary health behavior self-efficacy scale for functional dyspepsia patients,and supply a practical evaluation tool for clinical nurses.Methods Through literature review,group discussion and expert interview,the authors established the preliminary index system.The Delphi method was used to organize two rounds of 20 experts consultations.Results In the two rounds of expert consultations,experts positive coefficients were 100％,respectively.The authoritative coefficient of experts was 0.83,respectively.The Kendall's W coefficients were 0.23 and 0.29.The evaluation system included 5 dimensions,11 evaluation indicators,and 42 evaluation items.Conclusions The reliability of the self-efficacy scale developed with Delphi method is relatively high and it can acted as an evaluation tool for self-efficacy and health education of patients with functional dyspepsia.

Objective To study the extracranial and intracranial arterial hemodynamic changes before and after carotid artery stenting(CAS). Methods Thirty-eight patients with extracranial internal carotid arterial(EICA) stenosis were selected.Before and after CAS, the vessel diameter,the peak systolic velocity(PSV) in bilateral EICA and the PSV, pulsatility index(PI) in bilateral middle cerebral artery(MCA),ophthalmic artery(OA) were measured respectively by color Doppler flow imaging(CDFI) and transcranial color-coded duplex sonography(TCCD).Results Compared with pre-CAS,the diameter of ipsilateral EICA showed obviously increase post-CAS(P 0.05 ).The established collateral circulation were closed. Conclusions The extracranial and intracranial arterial hemodynamic data measured by CDFI and TCCD are valuable in evaluation of CAS.CAS is an effective and safe treatment for carotid stenosis,and the long time follow-up remains to be.

Objective To observe the safety and efficiency of DIVER thrombus aspiration catheter application during percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI)and to evaluate its impacts on the myocardial reperfusion,cardiac function and in-stent restenosis after 9months.Methods A total of 86 cases of ST-segment elevation patients of AMI treated with PCI and confirmed complete occlusion lesion by angiography from November 2008 to December 2010 were randomly divided into two groups:aspiration group(n =43)with DIVER thrombus aspiration cathetcrs were used,and non-aspiration group (n =43).ST-segment recovery within two hours,TIMI grade,the in-hospital adverse major cardiac events,the levels of Pro-BNP,coronary function determined by ultrasound heartbeat graph and the results of coronary angiography after PCI for 9 months were compared between two groups.Results There was significant difference on ST-segment recovery within two hours between these two groups[95.35％(41/43)vs 79.02％(34/43),x2 =11.862,P =0.0006].The incidence of TIMI 3 grade flow was significantly higher,the incidence of TIMI 2(slow flow)and TIMI 0-1(no-reflow)grade flow were much lower in aspiration group than those in non-aspiration group immediately after PCI[TIMI 3:93.02％(40/43) vs 81.40％(35/43),x2 =6.06,P =0.0335 ; TIMI 2:6.98％(3/43) vs 13.95 ％(6/43),x2 =3.12,P =0.0495 ; TIMI 0-1:0 vs 6.98 ％(3/43),x2 =5.29,P =0.0352].There was no difference on LVEF[(0.420±0.054) ％ vs(0.408±0.052)％,t =1.0496,P =0.766and LVEDD(56.5±4.5)mm vs(57.6±4.4)mm,t =1.0419,P =0.7832]between these two groups one day after PCL LVEF was significandy higher in aspiration group than that in non-aspiration group one and nine months after PCI[(0.452±0.050) ％ vs(0.432±0.049) ％,t =3.3957,P =0.0482 ;(0.469±0.053) ％ vs (0.413±0.052)％,t =4.9457,P =0.0336].LVEDD was significantly smaller in aspiration group than that in non-aspiration group one and nine months after PCI[(49.6±5.1) mm vs(53.4±4.6) mm,t =3.4548,P =0.0473 ;(46.5±4.4) mm vs(50.2±4.8) mm,t =3.7260,P =0.0421].There were no cardiovascular events (angina,myocardial infarction,heart failure,cardiac death)in both groups during 9 months follow-up.The coronary angiography results showed that the occurrence rate of in-stent restenosis in aspiration group was significantly lower than that in non-aspiration group(2.33％ vs 6.98％,x2 =4.4351,P =0.0463).Conclusion The application of DIVER thrombus aspiration catheters during PCI in all patients with AMI was safe and effective,it can improve the myocardial tissue perfusion and the post-operative cardiac function and can lower the occurrence rate of in-stent restenosis.

Objective To investigate the value of early quantified analysis of perinatal white matter injury by cranial ultrasound gray scale measurement. MethodsThe cranial ultrasound exam was performed in 152 newborns with different gestational age0 early after their birth. These newborns were divided into two groups: 104 newborns diagnosed as white matter injury within 7 days after birth were taken as patient group; while 48 newborns who were not were taken as control group. The gray scale values in the trigone of lateral ventricle of white matter were analyzed by medical image analysis system. The newborns in patient group accepted cranial ultrasound exam at one month after birth, the grey scale value and cyst in the white matter were recorded. Three to six months old, the cranial ultrasound exam was repeated to record the change of white matter volume, morphology of lateral ventricle and change of the cysts. When they were 1.5 to 2 years old, the neurological function were quantitatively evaluated with Gesell score, and the results were classified as normal and abnormal.The relationships between gray scale value and neuro-developmental outcome were analyzed with receiver operating characteristic curve.Results During neonatal period, the average gray scale values in severely injured group was 131.72±2.40, higher than that of mildly injured group (116.61±2.48), and which in mildly injury group was higher than that in control group (100.50±1.66) (q=4. 521 and 4. 492, P＜0. 05). It was showed by receiver operating characteristic curve that gray scale value ＞114.37 could help to diagnose white matter injury, with the sensitivity of 0. 721 and the specificity of 0. 854; gray scale value ＞119.80 could help to diagnose severe white matter injury,with the sensitivity of 0. 716 and the specificity of 0. 776.As the gray scale value increased, the incidence of white matter volume decreased and the enlargement of lateral ventricle in the later period of injury increased. Patients with gray scale value ＞ 130 tended to suffer from leucomalacia. During neonatal period, the incidence of abnormal neurodevelopment before 2 years old was 5.0％ in patients with gray scale value ＜ 110, while it was 27.8 ％ in the patients with gray scale value between 110 and 120, 47.8％ in the patients with gray scale value ＞ 120.Conclusions Quantified analysis of ultrasound gray scale value might be promising in early diagnosis of perinatal white matter injury through early judgement of the outcomes of white matter injury and forward neurodevelopment.

Objective To investigate the effects ofthrce generations oftretinoids on the apoptosis of and caspase expressions in human cutaneous squamous cell carcinoma cell line SCL-1. Methods SCL-1 cells were cultured in vitro in the presence of three tretinoins, namely all-trans retinoic acid (ATRA), acitrefln and tazarotene at a concentration of 1×10-5 mol/L. On day 1, 3, 5, MTT assay and ELISA were used to detect the cell proliferation and apoptosis of these SCL-1 cells respectively; on day3, flow cytometry with Annexin V/PI was applied to analyze the cell cycle and early apoptosis, Western blot to measure the protein expressions of caspase-8 and caspase-9 in these cells. Results The growth of SCL-1 cells could be inhibited by ATRA, acitretin or tazarotene of 1×10-5 mol/L in a time-dependent manner (all P<0.01). All the three tretinoids could induce the cell apoptosis of SCL-1 cells (P<0.01), arrest them in G1-phase, and activate caspase-8 and caspase-9 (F=35.50, 25.79, respectively, both P<0.01). Of the three tretinoins, acitretin exerted the strongest effect on all the parameters tested. Conclusions Tretinoins can inhibit the growth and induce the apoptosis of cutaneous squamous carcinoma cells, which may be mediated through Fas- and mitochondria-way.

Objective To investigate the molecular transduction mechanisms of apoptosis in cuta-neous squamous cell carcinoma cell line SCL-1 induced by acitretin. Methods SCL-1 cells were cultured and continuously treated with various concentrations of acitretin. Apoptosis was assessed by enzyme-linked immunosorbent assay (ELISA) in these cells on day 1, 3 and 5. Apoptotic cells were observed by acridine orange staining on day 5. The protein expressions of Fas, FasL, Fas-associated death domain (FADD), cas-pase-8, caspase-3 and poly ADP-ribose polymerase (PARP) were examined using Western blot in SCL-1 cells treated with acitretin at 1 x 105 mol/L at different time points. Neutralizing anti-Fas antibody (ZB4,1 μg/mL) was utilized to pretreat SCL-1 cells before the treatment with acitretin, following that, ELISA was done to compare the apoptosis in cells treated with ZB4, acitretin, or the combination of ZB4 and acitretin,respectively. Results Acitretin induced the apoptosis of SCL-1 cells in a dose- and time-dependent manner.Morphologically, acitretin-treated SCL-1 cells showed a typical characteristic of apoptosis. Significant increase in Fas, FasL, and FADD protein expression, as well as the activation of caspase-8, caspase-3 and PARP were induced by the treatment with acitretin. The apoptosis absorbance value was 0.78 ± 0.04 in cells treated with acitretin alone, decreased to 0.41 ± 0.03 in cells treated with ZB4 and acitretin (P ＜ 0.05), .suggesting that ZB4 could block the apoptosis of SCL-1 cells inducedby acitretin. Conclusion Acitretin could induce the apoptosis of cutaneous squamous cell carcinoma cells likely by Fas signaling pathway.