ObjectiveTo investigate the diagnosis value of intracardiac echocardiography in cesarean section scar pregnancy. MethodsCavity ultrasound was applied in patients of cesarean scar pregnancy with sonographic features and treatment. ResultsIn 52 patients, ultrasound diagnosed accurately in 45 cases, diagnosis accurate rate was 86.5％ (45/52). Sonogram showed gestational sac simply type in 16 cases, mixed echo-type( or mass-based) of 36cases. In 52 cases of CSP, according to their clinical and sonographic features ,2 cases of uterine scar lined laparotomy and the uterus excision repair;three cases of laparoscopic removal of uterine scar pregnancy lesion repair. 6 patients to methotrexate;five cases of abdominal surgery;36 routine uterine arterial embolization in the ultrasound monitor after curettage. ConclusionUltrasound could apply in cesarean scar pregnancy timely,and accurate diagnosis was made;sonographic features according to the patients,help choose the appropriate clinical treatment,and assess efficacy.

AIM: To explore the mechanism of nicotine against the apoptosis induced by colchicines in rat cortical neurons.METHODS: Cortical neurons were cultured from newborn Sprague-Dawley(SD) rats(less than 12 h).The rate of apoptosis was measured by Hoechst33258 fluorescence staining in the neurons,and the activity of Akt473 was analyzed by assay kit Akt473.RESULTS: The apoptosis of cortical neurons can be induced by 0.1 ?mol/L colchicine.The phosphorlation of Akt 473 decreased significantly(1/3 times of the control group,P

AIM:To establish the quality standard of Biling Weitong Granules (Rhizoma Corydalis, Radix et Rhizoma Rhei, Rhizoma Coptidis, etc.). METHODS: Rhizoma Corydalis, Radix et Rhizoma Rhei, Rhizoma Coptidis, Fructus Evodiae, Fructus Litseae were identified by TLC. The content of berberine hydrochloride was determined by RP-HPLC C_ 18 column(ODS, 250 mm?4.6 mm, 5 ?m) was used as chromatographic column. The acetonitrile-0.02 mol/L potassium dihydrogen phosphate (Adjust with phosphoric acid to a pH of 3.0) (25∶75) was used as mobile phase. The detection wavelength was at 347 nm. The flow rate was kept to 1.0 mL/min. RESULTS: The TLC sports developed were fairly clear, and the blank test showed no interference. The linearity of berberine hydrochloride was good in the range of 0.041 32-0.619 8 ?g(r= 0.999 9 ). The average recovery of berberine hydrochloride was 101.93%, RSD=0.60%(n=6). CONCLUSION: The method is simple, reliable, accurate and can be applied as the quantity control method of Biling Weitong Granules.

Objective:To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography (ECG) .Methods:A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Re-sults:(1) Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;(2) Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,(20.52 ± 2.46) mmHg vs .(49.65 ± 2.17) mmHg] ,pulmonary artery diastolic pressure [PADP ,(10.82 ± 2.04) mmHg vs .(21.93 ± 1.26) mmHg] and pul-monary artery mean pressure [PAMP ,(13.78 ± 3.67) mmHg vs .(26.67 ± 3.28) mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,(187.69 ± 12.46) dyn .s .cm-1 vs .(368.72 ± 11.94) dyn .s .cm-1 ] on 7d after pulmonary resection , P<0.05 all;all above indexes recovered to normal on 30d after treatment ;(3) Com-pared with before operation ,right ventricular Tei index significantly rose [ (0.36 ± 0.05) vs .(0.69 ± 0.13) , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion:Com-pared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .

Objective To investigate the relationship between aquaporin-4 (AQP4) expression level inbrain and dynamic change of brain edema in rats after cardiopulmonary resuscitation (CPR), and to evaluate the in-tervention effects of Edaravone. Method Totally 72 Sprague-Dawley male rats were randomly divided into fourgroups:normal group (n = 6, group A) ,shame-operated group ( n = 6, group B), CPR group including 1 hour,6 hours, 12 hours, 24 hours, and 72 hours after ROSC (5 sub-groups, n = 6for each,group C) ,edaravone-treat-ed group with the same time points as CPR groups(5 sub-groups, n = 6for each,group D). Asphyxia cardiac ar-rest with CPR model was used in group C and group D. Edaravone at a dose of 3.0 mg/kg was given intravenouslyand the same dose of edaravone was administered subcutaneously to the rats of group D after CPR. Anaesthosia,vascular cannulation and endotracheal intubation were pedormed in rats without asphyxia and CPR in group B. Ateach interval, the brain water content was calculated. The AQP4 expression level in brain tissue was determinedusing immunohistocbemical staining. Neurodeficit scores were assessed and pathological change was observed, Re-sults The brain water content in rats of group C increased obviously along with the prolongation of time followingROSC,and reached its peak at ROSC 24h,which was much higher than that of group B (P<0.01). Meanwhile,AQP4 expression in brain had a trend towards increasing and the integral optical density(iOD) and coloratian arearatio(△S) in group C were significantly increased compared with group B ( P<0.01). The trend of changes wasnearly the same as that of the brain water content. The correlation analysis demonstrated that AQP4 expression levelsuch as iOD (r=0.858, P < 0.01 ) and △S ( r = 0.870, P < 0.01 ) were correlated with the brain watercontents apparently. Compared with group C, the brain water content was decreased obviously (P<0.05), iODand △S was down-regulated at the same lime (P<0.01) in group D. The neurodeficit scores increased (P <0.05) and pathological damage was dramatieaUy ameliorated. Conclusions AQP4 expression increased greatly inbrain after CPR and the relationship between AQP4 and brain edema was positively correlated. AQP4 may play arole in the formation of brain edema following CPR. Edaravone could attenuated brain edema after CPR in rats byway of inhibiting the expression of AQP4. It had neuroprotective effect.

OBJECTIVE：To establish characteristic chromatogram of Cornus officinalis and its different wine-processedproducts，investigate the differences of chromaticity values，and analyze them with chemical pattern recognition technology.METHODS：UPLC method was adopted. Using loganin as reference，UPLC characteristic chromatograms were drawn for 10batches of C. officinalis and 20 batches of different wine-processed products （stewing with wine，steaming with wine）. TCMFingerprint Similarity Evaluation System（2012A edition）was used for similarity evaluation，and common peaks were confirmed.The chromaticity values [lightness（L），red and green tone value（a），yellow and blue tone value（b），color difference value（ΔE）]were determined by spectrophotometer. SPSS 20.0 and SIMCA 14.0 software were used for cluster analysis，principal componentanalysis and partial least squares-discriminant analysis；taking the area of characteristic peak and chromaticity value as indexes，andthe variable importance projection greater than 1 as the standard，the difference markers affecting its quality were screened.RESULTS：There were 6 common peaks in the chromatograms for decoction piece of C. officinalis，7 common peaks forwine-processed C. officinalis（stewing with wine）and wine-processed C. officinalis（steaming with wine）. Four components wereidentified as gallic acid，5-hydroxymethylfurfural，morroniside，loganin. 5-hydroxymethylfurfural was produced after processing.The similarity between C. officinalis and different wine-processed products （stewing and steaming with wine） was low（0.869-0.937，0.845-0.944），but the similarity between different wine-processed products was higher than 0.99. ΔL，Δa，Δb and ΔEof C. officinalis decoction pieces and wine-processed C. officinalis decoction pieces（stewing in wine）were －9.42-－3.58，－24.92- －15.00，－11.33- －7.00 and 17.01-28.12，respectively. ΔL，Δa，Δb and ΔE of C. officinalis decoction pieces and wine-processed C. officinalis（steaming in wine）decoction pieces were －8.58-－2.42，－25.08-－13.83，－10.92-－6.08，15.58-28.67. ΔL，Δa，Δb and ΔE of wine-processed C. officinalis decoction pieces（stewing and steaming with wine）were －2.17-3.00，－0.75-2.50， 0.25-1.42 and 1.25-3.83，respectively. Results of cluster analysis showed that 30 batches of sample were clustered into two categories，S1-S10 were clustered into one category，and S11-S30 were clustered into other category. Principal component analysis showed that cumulative contribution rate of former two main components was 83.147％. Results of partial least squares-discriminant analysis showed that morroniside，No.5 peak and chromaticity values（L，a，b）were the difference markers affecting its quality. CONCLUSIONS：Established UPLC characteristic chromatogram is stable and feasible，and can be used to rapidly identify C. officinalis and its different wine-processed products. Established chemical mode can be used to identify different wine-processed products.

Objective To study the pathogenic etiology between nasopharyngeal aspirates (NPA) and bronchoalveolar lavage lfuid (BALF) in children with lower respiratory infection. Methods Multiple pathogen in NPA and BALF from 210 cases with lower respiratory tract infection was detected. Seven common respiratory virus (respiratory syncytial virus, adenovirus, in-lfuenza virus A, inlfuenza virus B, parainlfuenza 1, parainlfuenza 2, parainlfuenza 3) were detected by direct immunolfuorescence assay. MP, CP and HBoV were detected by lfuorescence quantitative PCR.HRV and hMPV were detected by RT-PCR. Aspirates were cultured for bacteria. The results of pathogen detection in secretions of upper and lower respiratory tract were analyzed. Results Total positive detection rate of NPA and BALF in 210 cases was 91.9%(193/210), which is higher than that in NPA 75.2%(158/210) and that in BALF 85.2%(179/210). Bacteria detection rate in NPA was 13.3%(28/210), and 8.6%(18/210) in BALF, without signiifcant difference (P=0.118). Bacteria detection rate in NPA and BALF was of poor consistency (Kappa=0.262). Virus detection rate in NPA was 24.3%, which is higher than that in BALF15.2%. BALF-MP detection rate was 77.6%(163/210), signiifcantly higher than that in NPA 53.3%(112/210). There are 95.5%(107/112) cases with positive results in NPA-MP detec-tioncan also be detected in the BALF-MP. MP copies in BALF were signiifcantly higher than that in NPA (4.28×106 vs. 1.31×105), and its positive rate in NPA was still higher than that in BALF. MP detection rate in NPA in children with clinical course of longer than two weeks was much lower than those with clinical course of two weeks or less. Conclusions The pathogen detection of virus and MP in NPA can be used as a reference for lower respiratory tract infection. The joint detection of NPA and BALF can improve the detection power. The sensitivity of virus detection in NPA is higher than that in BALF. NPA pathogen detection of virus and MP is of great important evidence-based medicine in the diagnosis of lower respiratory infection. MP detection rate and its copies in BALF are signiifcantly higher than that in NPA. BALF detection is the supplement of pathogen diagnosis in severe or refractory lower respiratory infections.

Objective To explore the value of two dimentional colour Doppler flow image (2D-CDFI) combined with three-dimensional color power angiography (3D-CPA) in diagnosis of placenta accreta.Methods A total of 43 pregnant women at risk of placenta accreta selected from September 2010 to August 2015 were enrolled,and underwent 2D-CDFI and 3D-CPA to scan entire placenta.Taking the results of clinical outcome and delivery pathology of the placenta as standard,the ultrasound characteristics of 2D-CDFI and 3D-CPA were analyzed.Results Taking the results of clinical outcome and delivery pathology of the placenta as standard,24 were proved with placenta increta,3 patients with adherent placenta,2 patients with placenta percreta,14 patients with no placenta implantation.Out of 43 cases,29 cases displayed the placental thickening and rich blood vessels in placenta,and at interface of placenta and bladder wall in 2D-CDFI.For 2D-CDFI,19 cases were correctly diagnosed with placenta accrete,while 6 cases were mis-diagnosed and 4 cases missed diagnosed,the diagnosis coincidence rate by 2D-CDFI was 65.5％ (19/29).The ultrasound characteristics displayed irregular arranged myometrial arcuate artery,rich blood vessels at interface of placenta and bladder wall in 3D-CPA.For 3D-CPA,23 cases were correctly diagnosed with placenta accrete,3 cases were misdiagnosed,the diagnosis coincidence rate by 3D-CPA was 79.3％ (23/29).For 3D-CPA combined 2D-CDFI,1 case missed diagnosed,the diagnosis coincidence rate by combination 2D-CDFI with 3D-CPA was 96.6％ (28/29).Conclusions Placenta accrete can all be prenatally diagnosed by characteristic ultrasonic features of 2D-CDFI and 3D-CPA.But 3D-CPA can clearly display the range of placenta accrete lesions and the depth of the blood vessels diffused,has more advantage than two-gray scale ultrasound and 2D-CDFI and has broad application in clinic.

Objective To observe the application effect of extended Gamma 3 intramedullary nail close reduction in treatment of the subtrochanteric comminuted fracture. Methods A total of 80 cases of patients with subtrochanteric comminuted fracture treated in our hospital from January 2010 to December 2013 were selected as the research objects, and recieved closed reduction treatment, and they were randomly divided into the treatment group (n=46), which were given the treatment of extended Gamma 3 intramedullary nail, and the control group (n=34), which were given the treatment of dynamic hip screws. During the 12 months of postoperation follow up, the surgical results, fracture healing time, functional recovery and complications of the patients in two groups were compared. Results The operation time of two groups was (57.34±11.52) minutes vs (67.25±18.38) minutes, the amount of bleeding during operation was (145.78± 28.57) mL vs (264.55±25.26) mL, the time of hospitalization was (14.20±2.63) days vs (18.65±3.00) days and the time of fracture healing was (10.38 ±2.46) weeks vs (14.21 ±2.24)weeks. The differences were significant (P<0.05). In addi-tion, after one year of follow-up, the excellent rates of function recovery in two groups were 91.30%and 82.35%. There were no significant differences between them ( P>0 . 05 ) . The incidence of complications of the patients in the two groups were 2.17%and 17.65%. The differences were significant (P<0.05). Conclusion The subtrochanteric comminut-ed fracture is treated by closed reduction and application of extended Gamma 3 intramedullary nail, the functional re-covery of the patients is good and the complications are fewer. This method is worth the clinical promotion.

OBJECTIVETo investigate the clinical and biological characteristics of childhood acute myeloid leukemia(AML)with 8;21 translocation.

METHODSA retrospective analysis including clinical information, cell morphology, chromosome, immunophenotype and molecular biology was performed on 41 cases of childhood t(8;21)AML. The control group included 19 cases of AML without t(8;21) translocation detected during the same period.

RESULTSThe 41 cases of t(8;21)AML accounted for 68.3% of 60 continuous childhood AML patients. Among them, classical t(8;21) translocation was seen in 29 cases; variant t(8;21) translocation, simple 8q-, near-tetraploidy characterized by the duplication of t(8;21) translocation each came into view in 2 cases; and cryptic t(8;21) translocation was seen in 6 cases. Thirty seven cases (80.4%) belonged to M2 subtype of AML. Most of them had the morphological changes such as the leukemia cells' indent nucleus with a light stain region of perinucleus, basophilic cytoplasm, differentiation with maturation, megaloblastoid changes and nuclear-cytoplasm imbalance; the high expression of CD13 antigen; and the AML1/ETO fusion transcript in 23 cases examined by reverse transcription-polymerase chain reaction (RT-PCR) assay, including 6 cases with normal karyotype. The difference in complete remission rate between t(8;21) positive patients group and t(8;21) negative patients group was not significant in statistics (82.4% vs 75%, P>0.05). However the difference in recurring rate of the leukemia was statistically significant (10.7% vs 41.7%, P<0.05).

CONCLUSIONt(8;21)AML is the most frequent type of childhood AML. It is predominantly associated with M2 subtype of AML and has unique morphological, immunological prognostic features .

Acute Disease ; Adolescent ; Child ; Child, Preschool ; Chromosomes, Human, Pair 21 ; genetics ; Chromosomes, Human, Pair 8 ; genetics ; Female ; Humans ; Karyotyping ; Leukemia, Myeloid ; genetics ; pathology ; Male ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Translocation, Genetic