Objective To compare the fetal and maternal outcomes of labor undergoing epidural block anesthesia with and without using hand-and-knee position in the second stage of labor.Methods A total of 1,158 subjects were included in the study.There were 560 subjects in the study group and 598 cases in the control group.All the subjects were divided into study and control group according to the randomized numbers.Both groups underwent epidural block anesthesia and used the same labor way in stage I and stage 3.In the study group,the hand-and-knee position was used for 15～30 minutes combined with uterine contractions and the delivery was done in the lithotomy position.In the control group,the gradidea took the semi-recumbent position with bent knees and bed elevated 40°,combined with uterine contractions until the delivery was done in the lithotomy position.The labor time of stage1,stage2,stage3 and all abor,labor way,perinaueum,complications and newborns were compared.Results The average time of the second stage labor and all labor in the observation group were significantly shorter than those of the control group (P＜0.05).The labor ways in the observation group was better than that of the control group (P＜0.05).The incidence of postpartum urinary retention in the observation group was significantly lower than that of the control group (P＜0.05).The differences of labor time for stage 1,stage2,perinaueum,blood loss rate,newboms' s tomor and neonatal asphyxia between two groups were not statistically significant (P＞0.05).Conclusions Under continuous epidural block anesthesia,the use of the hands-and-knees position in the second stage of labor can reduce the incidence of operative delivery,shorten the labor process,and reduce maternal complications.The method is worthy of promotion.

Objective To evaluate the expression of RAR-? gene in cervical carcinoma cell lines SiHa,HeLa,C33A and Caski and to analyze the relation between their gene expression and the promoter methylation of RAR-? DNA.Methods The expression of mRNA and protein of RAR-? gene in the four cell lines were analyzed by RT-PCR,western blot and immunofluoreseence,respectively.Methylation specific PCR(MSP)was used to check whether there was methylation in the promoter of RAR-? gene.The demethylating agent 5-aza-2'-deoxycytidine(5-Aza-cdR)was used to treat methylated cell lines and the change of RAR-? gene methylation and RAR-? gene expression defects were observed.The cell proliferation was assayed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method.Results The mRNA and protein expression levels of RAR-? in cell lines SiHa,HeLa,Caski and C33A were 0.25 ?0.08,0,0.60?0.19,3.12?0.92 and 0.23?0.07,0,0.14?0.05,0.68?0.21,respectively.The mRNA and protein expression of RAR-? in SiHa,HeLa and Caski cell lines were decreased or silenced, whereas its expression increased in C33A cell line.MSP method showed that there were RAR-? gene methylation in SiHa,HeLa and Caski cell lines,while there was no RAR-? gene methylation in C33A cell line.After treated with 5-Aza-cdR,the mRNA and protein expression levels of RAR-? in SiHa,HeLa, Caski and C33A cell lines were 1.82?0.59,2.13?0.62,1.67?0.43,2.95?0.89 and 0.69?0.21, 0.83?0.29,0.56?0.16,0.64?0.20 respectively.The mRNA and protein levels of RAR-? had a significant difference between before and after interference with 5-Aza-cdR in SiHa,Helm,and Caski cell lines(P0.05).The 5-Aza-cdR treatment could suppress cell proliferation.Conclusions The RAR-? gene expression defects play an important role in the carcinogenesis of cervical cancer.Aberrant methylation in promotor region of RAR-? gene may be an important mechanism for the loss of expression of RAR-? gene.

To analyze the regularity in combined medication with Xiyanping injection (Xiyanping for short) in the real world by as- sociation rules. Totally 5 822 patients using Xiyanping injection was collected from the 18 Class III Grade I hospitals nationwide to study the combined medication information of the patient with lung infection and make the analysis by using association rules and Apriori. According to the results, major drugs combined with Xiyanping in treatment of lung infection included compound amino acid, inosine, coenzyme A, cytidine triphosphate, vitamin C. Common drugs combined with Xiyanping can be divided into 5 categories: nutrition support therapy (vitamin C, compound amino acid) , coenzymes (coenzyme A, cytidine triphosphate, inosine), expectorants and antiasthmatics (ambroxol, salbutamol, doxofylline), hormones (dexamethasone, budesonide), antibiotics (mainly cefminox). The main combined medicines mostly conformed to the regularity for drugs treating lung infection. In addition, there were two most common medical combination models: the model for Xiyanping combined a single medicine is Xiyanping + nutrition support therapy, while the model for Xiyanping combined two or more than two medicines is Xiyanping + nutrition support therapy + coenzyme. Pharmacologically, Xiyanping is mostly combined with western medicines with similar pharmacological effects to substitute or supplement the antibiotic effect in treating lung infection. However, further studies shall be conducted for the safety and rationality of the combined medication based on clinical practices, in order to provide reference for clinical medication.
Adult ; Anti-Bacterial Agents ; administration & dosage ; Ascorbic Acid ; administration & dosage ; Cephamycins ; administration & dosage ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hospital Information Systems ; Humans ; Lung Diseases ; drug therapy ; Male ; Middle Aged ; Young Adult

Objective To investigate the differences in visceral fat area measured by bioelectrical impedance analysis in different sex and age groups, and explore the relationship between visceral fat area and other metabolic risk factors. Methods This study enrolled 72 in-patients in the department of cardiology in Peking University First Hospital between August, 2014 and October, 2014. The visceral fat area and the subcutaneous fat area were measured by DUALSCAN HDS-2000 in all patients. Results were compared between different sex and age groups and the relationship between visceral fat area and metabolic risk factors were analyzed. Resu1ts Male had larger visceral fat area than female [ ( 114. 04 ± 38. 27 ) cm2 vs. (92. 09 ±30. 57)cm2, P=0. 019], while female had larger subcutaneous fat areas than male [(223. 92 ± 73. 58)cm2 vs. (270. 35 ± 82. 13) cm2, P =0. 019] . Subcutaneous fat area and visceral fat area were positively correlated in both male ( r=0. 777, P﹤0. 001) and female ( r=0. 601, P=0. 002). There were no significant differences in visceral fat area among different age groups (P=0. 582). And visceral fat area had a positive correlation with body mass index (r=0. 748, P﹤0. 001), waist-hip ratio (r=0. 577, P﹤0. 001), abdominal circumference (r =0. 752, P ﹤0. 001) and HbA1c levels (r =0. 413, P =0. 001). Conc1usions There are sex differences in visceral fat area and subcutaneous fat area. The visceral fat area max be related to blood glucose levels and presence of diabetes.

Objective:To investigate the correlation between anthropometric indices and arteriosclerosis detection indicators in the middle-aged and the elderly .Methods: A cross-sectional descriptive study was made of 1 626 individuals ( diabetics patients 23.37%, hypertensive subjects 39.48% and healthy individuals 37.15%), aged 45 to 90 years [mean age:(61.60 ±10.22) years)] in Shijingshan Dis-trict, Beijing.Their measurements:body mass index (BMI), waist circumference (WC), and waist to height ratio ( WHtR ) .Arterial stiffness was assessed according to brachial-ankle pulse wave velocity (baPWV), intima-media thickness (IMT), augmentation index (AI) and ankle-brachial index (ABI), which were measured by noninvasive detectors and equipment .The correlations between the various indi-cators were analyzed .Results:The percentages of the hypertensive and diabetic groups of central obesity ( male WC>85 cm, female WC >80 cm or WHtR>0.5 ) and of general obesity ( BMI>28 kg/m2 ) were significantly higher than those of the healthy group ( P<0 .01 ) .The difference between the two disease groups was not significant ( P>0 .05 ) .There was a moderate positive correlation between the measures of abdominal obesity (WHtR and WC) and the general obesity indicators (BMI) (r=0.710 and 0.716) .In the healthy group , WC and WHtR showed positive correlation with baPWV , IMT and ABI, and negative correlation with AI 75 .BMI showed positive correlation with IMT and negative correla-tion with AI75 , and no correlation with baPWV and ABI .There was negative correlation between BMI and baPWV in the diabetic group .In the hypertension group , we found negative correlation between BMI and baPWV, maximum IMT, AI75 , and also between WC and AI 75 .The simple regression straight line of baPWV versus the anthropometric parameters showed that the regression equations were y =0 .949 +1.379 x (baPWV vs.WHtR, R2 =0.046, P<0.001) and y=1.133+0.006x (baPWV vs.WC, R2 =0.027, P<0.001), respectively.baPWV and BMI did not have a linear relationship (P =0.62). Conclusion:WHtR and WC are superior to BMI indices in predicting arteriosclerosis .Anthropometric measurements for central obesity are good predictors of cardiovascular risk .

Objective To investigate the role of visfatin in the pathogenesis of gestational diabetes mellitus (GDM)and its correlation with insulin resistance.Methods The study recruited 58 pregnant women of 24 to 28 gestational weeks in People' s Hospital of Hebei Province from January to June 2013.Among them,30 were patients with GDM (GDM group),28 had normal oral glucose tolerance test and was referred as healthy pregnancy group (NGT group).Fourteen age-matched female who were first-degree relatives (FDR1)of type 2 diabetes mellitus patients,and 27 healthy nonpregnant women with normal oral glucose tolerance test were referred as high-risk group and normal controls (NC),respectively.The fasting plasma glucose (FPG),1 hour and 2 hours postprandial glucose levels were measured by glucose oxidase method.The fasting insulin (FIN)levels were measured by radioimmunoassay and the homeostatic model assessment-insulin resistance index (HOMA-IR)was calculated.The levels of total cholesterol (TC),triglycerdes (TG),high density lipoprotein cholesterol (HDL)and low density lipoprotein cholesterol (LDL)were determined.The visfatin levels were measured by ELISA.Results (1)The levels of FPG were significantly higher in GDM,FDRI and NC group [(5.5±0.7),(5.1±0.6),(5.2±0.4) mmol/L] than that in NGT group [(4.5 ± 0.3) mmol/L],respectively (P＜0.05).(2) The levels of INS [(14 ± 6) mU/L],HO MA-I R (4.0±2.0),1 hour [(10.9± 1.8) mmol/L] and 2 hours [(8.6± 1.8) mmol/L] postprandial glucose levels of GDM group were significantly higher than those in NGT group [(12±4) mU/L,2.0± 1.0,(7.4± 1.3) and (6.2 ±0.9) mmol/L],respectively (P＜0.05).(3)The levels of TC,TG,HDL and LDL levels in GDM group were (5.5±0.9),(2.8±0.8),(1.8±0.4)and(3.3±0.8) mmol/L,and were(5.9 ± 0.8),(2.5 ± 0.7),(1.9 ± 0.4) and (3.4 ± 0.6) mmol/L in NGT group.The levels of lipid in the two groups were significantly higher than those in FDR 1 or NC group,respectively (P＜0.05).(4) The levels of visfatin in GDM group and NGT group [(43 ± 10),(45 ± 12) μg/L] were significantly higher than that in FDR1 or NC group [(29±9),(36±7) μg/L],respectively (P＜0.05),but the visfatin levels in FDR 1 group were significantly lower than that in NC group (P＜0.05).The visfatin levels in GDM group were slightly lower than that in NGT group,but the difference was not statistically significant (P＞0.05).(5)The visfatin levels in NGT group were negatively correlated to the levels of FPG,HOMA-IR and TC(r=-0.38,-0.44,-0.47,respectively,P＜0.05).But the visfatin levels in GDM group were not correlated with the levels of FPG,HOMA-IR,TC (r=-0.16,-0.01,0.33,respectively,P＞ 0.05).While in NC group,the levels of visfatin were negatively correlated with FPG and 2 hours postprandial glucose (r=-0.48,-0.42,respectively,P＜0.05).Conclusion Visfatin may be an important adipokine that involved in the carbohydrate and lipid metabolism in GDM,and is related to the pathogensis of GDM and insulin resistance.

Objective: To investigate the treatment efficacy of radiofrequency ablation (RFA) of hepatic tumors and the relevant complications. Methods: A total of 343 patients with 778 hepatic tumors underwent ultrasound-guided RFA (582 procedures). There were 212 cases of hepatic cellular carcinoma (HCC) with 448 tumors, and the average largest diameter was 4.0 cm.Of all the patients, 63 (29.7%) were in the stage of Ⅰ-Ⅱ(UICC Systems) and 149 (70.3%) in stage of Ⅲ-Ⅳ(including 43 patients with tumor recurrence after surgical resection). There were 131 cases of metastatic liver carcinoma (MLC), with 330 metastases in the liver, the average diameter was 3.9 cm, and the liver metastases of 91 patients (69.5%) came from gastrointestinal tract. The patients were treated using the relatively standard protocol. Crucial attention must be paid to monitoring the abnormal changes in ultrasound images as well as the vital signs of the patients to find the possible hemorrhage and peripheral structure injury in time. The tumors were considered ablated successfully if no viability was found on enhanced CT within 24 hours or 1 month after RFA. The patients were followed up for 2 -62 months.Results: The ablation success rate for HCC was 95.5% (428/448 tumors), and the rate for MLC was 96.4% (318/330 tumors). The local tumor recurrence rates for HCC and MLC were 8.5 % (38/448 tumors) and 11.8 % (39/330 tumors), respectively. A total of 138 patients (40.2%) underwent repeated ablations for 2-11 times because of tumor recurrence or metastasis. The first,second and third years survival rates were 87.7% , 67.4% and 56.8% for HCC patients, 81.6%, 50.8% and 27.2% for MLC patients,respectively. The survival rate from 63 early-stage HCC patients were 92.9%,82.8% and 74.5%, respectively. The major complication rate in this study was 2.4 % (14 of 582 procedures).The complications which consisted of mechanical and thermal injuries usually occurred during or shortly after the RFA treatment. There were 5 hemorrhages, 1 colon perforation, 5 injuries of adjacent structures, 2 bile leakages and 1 skin burn. Conclusion: RFA, as a minimally invasive local treatment, has become an effective and relatively safety alternative for the patients of hepatic tumors, even of advanced live tumor, tumor recurrence, liver metastases which are unresectable or difficult to treat with traditional therapies. Knowledge about possible complications and their control may increase the treatment efficacy and help to promote the use of RFA technique.

The aim was to study the morphological, histochemical and immunological characteristics of less-differentiated acute myeloid leukemic cells, and their diagnostic significance. Wright-Giemsa and histochemical staining were used to stain bone marrow smears from 2 case of AML-Mo. Immunological phenotypes were determined with flow cytometry. The results showed that myeloperoxidase stainings of both cases were negative, PAS was positive with fine particles, CD33/CD13 were positive, CD2/CD3/CD10/CD19/CD22 were negative. It is concluded that morphology, histochemistry and immunological phenotype on bone marrow smears are the main diagnostic basis for AML-Mo. The use of multiple monoclonal antibodies for staining may improve the accuracy.
Cell Differentiation ; Female ; Humans ; Leukemia, Myeloid, Acute ; classification ; immunology ; pathology ; Middle Aged

In this study, we cloned the NS3 gene from bovine viral diarrhea virus (BVDV) VEDEVAC strain. The result showed that the average P-distance of Pestivirus NS3 amino acid sequence was 0.07 and the VEDEVAC strain was classified to BVDV type 1. Using pET-30a(+) as vector and Escherichia coli Rosetta (DE3) as host, we obtained purified recombinant NS3 protein by Ni-NTA affinity chromatography. Western blotting analysis demonstrated that both BVDV positive serum and classical swine fever virus (CSFV) positive serum were able to recognize the recombinant NS3 protein. Indirect-ELISA assay indicated that the protein could be used as detection antigen.
Animals ; Cattle ; Cloning, Molecular ; Diarrhea Viruses, Bovine Viral ; genetics ; immunology ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics ; Peptide Hydrolases ; genetics ; immunology ; Phylogeny ; RNA Helicases ; genetics ; immunology ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; Sequence Analysis, Protein ; Viral Nonstructural Proteins ; genetics ; immunology

OBJECTIVETo assess the survival of radiofrequency ablation (RFA) and investigate the prognostic factors affecting overall survival, local recurrence-free survival and disease-free survival in hepatocellular carcinoma (HCC).

METHODSA total of 192 HCC patients underwent RFA treatment in our department and were enrolled into this study. Among them, 151 patients were males and 41 were females (mean age, 59.2 years, range, 24 - 87 years old). The average tumor size was (3.9 +/- 1.3) cm (range, 1.2 - 8.0 cm). Of these 192 HCC patients, their Child-Pugh grade of A, B and C were 106, 77 and 9, respectively. According to UICC-TNM system, 57, 85, 44 and 6 patients were in stage I, II, III and IV respectively. Kaplan-Meier model and log-rank test were used in univariate analysis and COX regression model was used in multivariate analysis to identify prognostic factors for survival.

RESULTSThe 1-, 2-, 3- and 4-year overall survival were 84.9%, 69.1%, 60.4% and 52.8%, respectively. Local recurrence-free survival were 75.1%, 53.8%, 43.9% and 40.8%, respectively. Disease-free survival were 64.3%, 43.2%, 37.1% and 25.0%, respectively. The following factors were identified as independent prognostic factors for survival by multivariate model: (1) Overall survival: Child-Pugh classification, standard treatment protocol and UICC-TNM staging. (2) Local recurrence-free survival: Child-Pugh classification and UICC-TNM staging. (3) Disease-free survival: UICC-TNM staging, Child-Pugh classification and daughter lesion. Among these, both Child-Pugh classification and UICC-TNM staging were independent prognostic factors for three kinds of survivals.

CONCLUSIONSDegree of tumor progress (UICC-TNM stage, daughter lesion), treatment method (applying of standard treatment protocol) and patients' liver function are the most important factors for survival after RFA. So application of proper treatment strategy before, during and after RFA should be required to improve survival.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; mortality ; pathology ; surgery ; Catheter Ablation ; Female ; Humans ; Liver Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Prognosis ; Survival Analysis ; Survival Rate