Objective To explore the prenatal ultrasonographic features of fetuses diagnosed as echogenic bowel and chromosomal abnormalities. Methods From September 2009 to June 2013, eighty cases diagnosed as echogenic bowel by prenatal ultrasound screening in our hospitals underwent chromosomal karyotype analysis and were followed up till fetal birth. The prenatal ultrasonographic features were carefully correlated with the postnatal findings. Results Prenatal ultrasoundand chromosomal findings of the 80 cases were:(1) Fifty-eight cases of fetuses with echogenic bowel alone (72.5%, 58/80, without chromosomal karyotype abnormalities). (2) Eleven cases of fetuses with additional ultrasound soft markers (13.8%, 11/80, without chromosomal karyotype abnormalities). The ultrasound examination revealed 8 cases of choroid plexus cysts, 1 case of single umbilical artery, 1 case of shorter nasal bone, and 1 case of echogenic intracardiac focus. (3) Five cases of fetuses with severe functional abnormalities or complex structural malformations and normal chromosomal karyotype. The ultrasound examination revealed 3 cases of structural cardiac malformations, 1 case of heart failure and 2 cases of central nervous system malformations. Of them,one case showed complex malformations (right ventricular dysplasia syndrome, cerebellar dysplasia and single umbilical artery), whereas the remaining 4 cases only involve single malformation. (4)Six cases had chromosomal abnormalities (7.5%, 6/80), including 3 cases of abnormal chromosome microdeletions, and 3 cases of abnormal chromosome numbers (1 21-trisomy syndrome, 1 18-trisomy syndrome, and 1 triploid syndrome). All of them had severe structural malformations and abnormal soft markers. The ultrasound examination revealed 2 cases of severe cardiac malformations, 2 cases of central nervous system malformations, 1 case of pericardial/peritoneal effusion, and 1 case of placental chorionic multiple hemangioma. One case of holoprosencephaly (donor of the twins) ended with intrauterine death. The associated abnormal soft markers include nuchal fold (NF) thickening, choroid plexus cysts, umbilical cord cysts, single umbilical artery, and placental chorionic hemangioma. Conclusions The fetuses with echogenic bowelaloneusualyhaveagoodprognosis.Insomecases,echogenicbowelmaydisappearduringvfolow-up.The fetuses complicated with severe structural malformations and chromosomal abnormalities have poor prognosis. For the fetuses diagnosed of echogenic bowel by prenatal ultrasound screening, systematic ultrasound examination should be carried out and clinical chromosomal karyotype analysis was suggested.

OBJECTIVE:To establish the essential medicine bidding evaluation model and improve the scientificity and effec-tiveness of essential medicine bidding and procurement. METHODS:Combined with the main objective of essential medicine cen-tralized bidding and procurement,a criteria bidding evaluation index system for essential medicine was established,and a bidding evaluation model for essential medicine was built based on fuzzy group decision making and the feasibility was verified by exam-ples. RESULTS:The essential medicine evaluation model based on fuzzy evaluation and group decision making was established, and empirical analysis for Atorvastatin Calcium tablet was used to show the feasibility of evaluation model. CONCLUSIONS:The essential medicine evaluation model based on fuzzy group decision making can scientifically and effectively accomplish a compre-hensive evaluation of pharmaceutical enterprises,which builds the foundation for promoting the transparency of essential medicine bidding and procurement work and reducing the economic burden for the patients.

OBJECTIVE:To provide reference for replenishing and perfecting essential medicine selection method in China. METHODS:According to the requirements of essential medicine selection,based on the actual situation,target function and restraint conditions for essential medicine selection could be determined by the knapsack theory and the essential medicine selection model could be built. The feasibility of established model was analyzed by an sample. RESULTS:The objective function of estab-lished model was Min∑CjXj,the minimum cost of all the selected essential medicines. Other constraints included covered range of disease,ADR,contraindications,attentions,dosage forms and specifications. Nine kinds of common oral hypoglycemic drugs were selected as candidate drugs,from which glipizide,gliclazide,metformin and repaglinide were chosen as the essential hypogly-cemic medicines with the proposed model. CONCLUSIONS:Established essential medicine selection model based on knapsack the-ory is scientifical,objective and with strong practicality.

Oral feeding of water cannot be accomplished in some critical patients due to coma, mouth-breathing or long-term indwelling of gastric tube, causing dry mouth which results in oral pain, ulcer, or infection, aggravating patients' discomfort and even affecting the prognosis. To solve this problem, the medical staff of the First Hospital of Jiaxing developed a novel oral humidifier and obtained the National Utility Model Patent of China (ZL 2019 2 0066979.0). The oral humidifier consists of a spraying device and a fixation device. The spraying device is a spraying housing with a water tank, and a spraying port where nanometer water mist can be emitted. The spraying housing is also equipped with a flashlight with a switch, and a schematic diagram of pupil size, which can be used to assess the pupil size conveniently. The fixing device is composed of a fixing frame, an adjustable rod and a clamp. The two ends of the adjustable rod are connected to the fixing frame and the clamp respectively, and can be adjusted to proper shape. The spraying housing can be placed on the fixing frame and installed on the bed and adjusted to the proper position quickly. This novel oral humidifier is a simple device which combines a spraying system with a pupil evaluation tool, implying significant clinical application in improving the convenience of nursing and alleviating dry mouth of critical patients.

The cell-free plasma DNA (cfpDNA) has been suggested as a useful tumor marker for its quantitative and qualitative tumor-specific alterations that reflect the biological characteristics and the progression and outcomes of tumors.Therefore,it has been used as liquid biopsy to detect cfpDNA in peripheral blood for the diagnosis,monitoring of clinical effects,and prognosis of malignancies

Objective To assess the coronary flow reserve in the patients with systemic lupus erythematosus(SLE)by transthroracic echocardiography(TTE).Methods Coronary sinus blood flow of 24 SLE patients and 18 matched healthy controls were assessed by TTE.The coronary flow reserve was calculated as the ratio of hyperemic to baseline blood flow.Hyperemia was induced by intravenous administration of dipyridamole.Results Adequate recordings of blood flow in the coronary sinus under both conditions were obtained by TTE in all study subjects.Patients with SLE were found to have significantly decreased coronary flow reserve comparing with normal SUbiects(1.55±0.21 versus 2.51±0.33.P＜0.01).Conclusions Coronary flow reserve can be measured by TTE in SLE patients,Coronary flow reserve is impaired suggesting that SLE patients may have subclinical coronary artery disease.

Objective To study the relationship between clinicopathological features and central lymph nodes metastasis in patients with papillary thyroid microcarcinoma(PTMC).Methods From Jan.2013 to Jun.2013,400 cases with PTMC in cN0 stage undergoing thyroidectomy and central neck dissection were collected.Results Univariate analysis showed that the rate of central lymph node metastasis in PTMC was 28.0％,nevertheless,the rate of central lymph node metastasis was 32.5％,42.6％,44.1％,33.3％,and 37.4％ respectively in patients aging below 45 years old,in male patients,in patients with extrathyroidal extension,in patients with tumor diameter larger than 5 mm and in patients with multifocality.Gender,age,extrathyroidal extension,tumor diameter,multifocality of patients had correlation with central lymph node metastasis.Multivariate binary logistic regression analysis revealed that the rate of lymph node metastasis significantly increased in cases of male,ageing below 45 years old,with extrathyroidal extension and multifocality(P ＜ 0.05).Conclusions The treatment for central lymph node metastasis of PTMC should be different considering elements including gender,age,multifocality of the tumor,and extrathyroidal extension.Prophylactic central lymphadenectomy should be performed when the primary lesion was resected.

Objective To analyze the expression characteristics of annexin A2 in dermal papilla cells (DPCs) with aggregative behavior.Methods Reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot were performed to measure the mRNA and protein expressions of annexin A2 respectively in DPCs with or without aggregative behavior.Results The mRNA expression level of annexin A2 was significantly higher in DPCs with aggregative behavior than in those without aggregative behavior (0.50 ± 0.15 vs.0.35 ± 0.19, t =8.26, P ＜ 0.05).Western blot showed that annexin A2 had two isoforms, including one isoform with a relative molecular mass of 40 000 and the other one with a relative molecular mass of 36 000.The annexin A2 isoform with a relative molecular mass of 40 000 was highly expressed in both DPCs with aggregative behavior and those without aggregative behavior, while the other isoform was only expressed in DPCs with aggregative behavior.Conclusion Annexin A2 may be closely related to the aggregative growth of DPCs.

OBJECTIVE To study the characteristic of epidemiology of hospital infection among recipients after liver transplantation and to probe into its risk factors.METHODS Totally 193 cases were investigated.The infection group was compared with the non-infection group.Descriptive statistics and risk factor analysis were performed with SPSS11.0.RESULTS Forty nine cases took place infection.The infection rate was 25.4% and the death rate was 20.41%.15 cases(30.61%) happened 2 or 3 time infections.Mid-time of infection was 14d.Twenty six case(30.61%) infection occurred within 4 weeks and 25 cases(51.02%) were on June and July.Pulmonary infection(32.84%),wound infection(31.34%) and abdominal cavity infection(23.90%) were ranked in front.A total of 693 strains were isolated,and Gram-negative(G-) bacilli were 42.14%,Gram-positive(G+)cocci 35.30% and fungi were 22.66%.The three risk factors were obviously correlated with the infection(P

Objective: To investigate the expression of recombinant human intedeukin-18 (hIL-18) in 3.7 L fermenter with the constructed engineer train Pichia pastoris X-33/hIL-18, and the procedures of expression and purification thereof.Methods: The train X-33/hIL-18 was inoculated in BMGY medium and then inoculated into the fermenter until the A600 of the culture reached about 6. The supernatant of fermentation was isolated and purified with centrifugal fiher devices, hydrophobic chromatography column and anion exchange chromatography column. Results: The recombinant hIL-18 was expressed in 3.7 L fermenter with batch feed methanol and the concentration reached 202 mg/L. After the purification, the purity could be more than 97%. The recombinant hIL-18 was shown to induce interferon-gamma (IFN-γ) production by human peripheral blood mononuclear cells (PBMCs), and enhanced NK cell cytotoxicity synergistically with IL-2. Conclusion: A great deal of the recombinant hIL-18 with higher purity could be harvested by Pichiapastoris expression system. This study showed a new potential for further study of its function and activities.