Objective To discuss the clinical efficacy and complication of using polypropylene net in pelvic floor reconstruction to treat pelvic floor organ prolapsus. Method From October 2007 to May 2008,15 cases of organ prolapsus of many region defect in pelvic cavity were operated pelvic floor reconstruction, 14 cases had three regional defects,and 1 case had two regional defects. Results All the cases were punctured smoothly without hematoma and injury of blood vessel and organs. The time of operation for 15 cases ranged from 60 to 150 minutes,averaged (85.0±4.3) minutes. The amount of bleeding in operations ranged from 150 to 400 ml,averaged (200.0±0.1) ml. Fifteen cases recovered well after operation without infection.The days in hospital were 5-9 days,averaged (6.0±0.7) days. Following up 1-12 months,pelvic floor structure of all patients were normal,and interrelated symptom disappeared or improved. One case was discovered the net was eroded after 5 weeks. Conclusions Pelvic floor suspension by vagina is a micro operation to treat complicated pelvic floor organ prolapsus. It can accomplish pelvic floor reconstruction and reserve uterus simultaneously, healing efficacy is stable in short-term,but need further observation.

Objective To explore the value of the combined detection of helper T lymphocyte (Th)1 and 2 type cytokines ex‐pression in the evaluation of acute pancreatitis severity and treatment efficacy .Methods From May 2009 to June 2013 ,the enzyme‐linked immunosorbent assay (ELISA ) was adopted to detect the expression levels of Th1‐type cytokineinterferon‐γ (IFN‐γ) and Th2‐type cytokine interleukin (IL)‐4 in 32 cases of mild acute pancreatitis (MAP group) and 18 cases of severe acute pancreatitis (SAP group) on 1 ,4 ,7 d after admission as well as 15 cases of normal healthy people (control group) .Results The test results of IFN‐γ on 1 ,4 ,7 d after admission in the MAP group were (31 .47 ± 4 .35) ,(36 .92 ± 4 .12) ,(49 .09 ± 4 .97)ng/L ,which of IL‐4 were (54 .72 ± 5 .52) ,(45 .26 ± 4 .89) ,(39 .79 ± 3 .85)ng/L .The test results of IFN‐γ on 1 ,4 ,7 d after admission in the SAP group were (23 .97 ± 5 .39) ,(26 .29 ± 3 .47) ,(33 .64 ± 4 .47)ng/L ,and which of IL‐4 were (70 .45 ± 5 .05) ,(65 .99 ± 4 .58) ,(56 .23 ± 4 .23)ng/L .The test results of IFN‐γ and IL‐4 in the normal control group were (49 .26 ± 20 .67)ng/L and (35 .15 ± 16 .32)ng /L respectively .Compared with the normal control group ,the expressions of Th1‐type cytokine IFN‐γ in the MAP group (except which on 7 d) and peripheral blood Th1‐type cytokine IFN‐γ in the SAP group were decreased and the expression of Th2‐type cyto‐kine IL‐4 was increased ,the difference was statistically significant (P< 0 .05) ;The test results of each index in the same treatment time had statistically significant differences between the SAP group and the MAP group (P< 0 .05) .Conclusion The obvious po‐larization of Th1‐type cytokine and Th2‐type cytokine exists in acute pancreatitis ,and the polarization degree is related with the se‐verity of disease .The combined detection of Th1‐type cytokine and Th2‐type cytokine is beneficial to judge the extent of serious condition and treatment effect of acute pancreatitis .

Idiopathic membranous nephropathy(IMN) is one of the main pathology of nephrotic syndrome,and has a rising trend year by year.In recent years that IMN is organ specific autoimmune disease.Phospholipase A2 receptor(PLA2R) and thrombospondin type-1 domain containing 7A(THSD7A) are the two main antigens of IMN,which could be used to distinguish the IMN and secondary membranous nephropathy.The anti-PLA2R antibody and anti-THSD7A antibody are associated with diagnosis,severity and activity of the disease.The antibody titer and its change could be used to help deciding the beginning of therapy and the therapitive courses.

Objective To investigate the expression of type Ⅱ and type Ⅲ iodothyronine deiodinases (D2 and D3 ) of human placenta on pregnant women with different thyroid diseases and different autoimmunity.Methods Pregnant women with different thyroid diseases and autoimmunity were selected into the experiment group,and pregnant women who had no individual or family history of thyroid diseases with normal thyroid function and negative thyroid peroxidase antibody (TPOAb) were selected into the control group.Expression level of iodothyronine deiodinase( D2 and D3 )on placenta was measured by RT-PCR.Results D2 and D3 were both expressed on human placenta.D2 showed significantly higher expression level in hypothyroidism uncontrolled group than that in control group ( 0.916 ± 0.035 vs 0.833 ± 0.029,P ＜ 0.05 ),however,D3 showed a lower expression(0.766 ±0.038 vs 0.848 ±0.052),on placenta and the difference was not significant(P ＞ 0.05 ).In those who had history of hyperthyroidism or hypothyroidism but whose thyroid function become normal by effective treatment,D2 and D3 expression exhibited no difference from that of the control(P ＞ 0.05).In those pregnant women with normal thyroid function and TPOAb-positive,D2 and D3 expression was (0.842 ± 0.032 ) and ( 0.837 ± 0.053 ) respectively and there was also no difference from that of the control( P ＞ 0.05 ).Conclusion D2 and D3 were simultaneously expressed on human placenta.In those pregnant women with hypothyroidism,the level of D2 expression is high and the level of D3 expression is low.Those changes might be important and helpful for the stabilization of thyroid hormone transportation between mother and fetus.

Objective To investigate the clinical effect of magnesium sulfate combined with nifedipine in the treatment of patients with pregnancy induced hypertension( HDCP) .Methods Retrospective study was used in this study and 116 patients with HDCP from January 2013 to July 2015 in department of obstetrics and gynecology from our hospital were divided into two groups, including routine group of 62 patients who received routine treatment +magnesium sulfate) and combination group of 54 patients who received routine treatment +magnesium sulphate +nifedipine.The clinical effect was analyzed after five days’ continuous treatment.Results The systolic blood pressure, diastolic blood pressure,24h urinary protein, random urine protein /creatinine,serum homocysteine (Hcy) and CRP values in combination group were lower than routine group (P<0.05).There were no statistical difference in maternal uterine inertia, neonatal asphyxia, fetal distress, postpartum hemorrhage rate between the two groups after the treatment.But the rate of cesarean section in the combination group(50.00%)was significantly lower than that in the routine group(68.25%)(P <0.05).Conclusion Magnesium sulfate combined with nifedipine in the treatment of patients with HDCP had better antihypertensive effect, and would not increase fetal adverse birth outcomes incidence and significantly reduce the rate of cesarean section.

ObjectiveTo investigate the influence of positive serum thyroid peroxidase antibody (TPOAb) on pregnancy outcomes in biochemically euthyroid women during gestation.MethodsFrom July 2006 to December 2010,in the prenatal care unit all pregnant women,who had no medical and family history of thyroid diseases,underwent thyroid function screening.Serum TPOAb was tested among those pregnant women with euthyroidism.Pregnancy outcomes,including obstetric complications,neonate birth weight,and Apgar score,were compared between 185 TPOAb positive women and 1417 TPOAb negative women.ResultsCompared with TPOAb negative women,it was more frequent for TPOAb positive women to suffer from various obstetric complications.The prevalences of umbilical cord entanglement ( 18.9％ vs 12.9％,RR =1.47,95％ CI 1.06-2.03,P＜0.05 ),threatened premature delivery or abortion (3.8％ vs 1.0％,RR =3.83,95％ CI 1.57-9.37,P＜0.05 ),intrauterine growth retardation (5.4％ vs 0.8％,RR =6.96,95％ CI 3.00-16.17,P＜0.01 ),and neonatal pneumonia ( 4.9％ vs 1.3％,RR =3.83,95％ CI 1.75-8.40,P＜0.01 ) in the group of TPOAb positive women were higher than those in the group of TPOAb negative women.Apgar score of those newborns whose mothers had positive TPOAb was 9.27 ±1.13 at one minute and 9.44 ± 1.09 at five minutes,being lower than that of the TPOAb negative group (9.49 ±0.69 and 9.68 ±0.52,both P＜0.01 ).The rate of newborns with Apgar score at 7 or less by 5 min in group with positive TPOAb was higher than that of group with negative TPOAb ( 1.6％ vs 0.1％,RR =11.49,95 ％ CI 1.93-68.31,P＜ 0.05 ).ConclusionsThese results indicate that pregnant women with normal thyroid function but positive TPOAb may be liable to increase risk of serious pregnancy outcomes,such as threatened premature delivery or abortion,intrauterine growth retardation,and a lower Apgar score in neonatal.

Objective To investigate the prevalence of thyroid disorders and positive thyroid autoantibodies,and evaluate the necessity for universal thyroid screening during the second and third trimesters of pregnancy.Methods The pregnant women during the second and third trimesters who visited Shanghai Jiaotong University Affiliated First People's Hospital between June 2006 and February 2008 were chosen for thyroid screening by determining serum free triiodothyronine,free thyroxine,thyrotropin,thyroid peroxidase antibody (TPOAb),and thyrotropin receptor antibody.A personal and family history of thyroid disease and other autoimmune diseases was investigated by questionnaire.The pregnant women were divided into high risk or low risk groups for thyroid disease based on their personal or family histories.Results A total of 2 101 pregnant women were screened,712 ( 33.89％ ) of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody.The prevalence of thyroid dysfunction was increased in high risk group.While in low risk group( n =1 983 ),the prevalence of clinical hypothyroidism was 2.27％ ( n =45 ),subclinical hypothyroidism 11.60％ ( n =230 ),clinical hyperthyroidism 0.20％ ( n =4 ),subclinical hyperthyroidism 1.06％ ( n =21 ),hypothyroxinemia 6.45％ ( n =128 ),and euthyroid with positive TPOAb 10.74％ ( n =213 ) in our study.Pregnant women with positive TPOAb were susceptible to thyroid dysfunction.It was shown that 79.74％ of pregnant women with thyroid disorders were diagnosed by universal thyroid screening.Conclusions 33.89％ of pregnant women in the second and third trimesters were identified to suffer from thyroid disorders or positive thyroid autoantibody by universal thyroid screening.Increased prevalence of thyroid dysfunction was found in pregnant women with positive TPOAb.79.74％ of pregnant women with thyroid disorders might be missed if screening was made only in the high risk cases.

Objective To fabricate a silk fibroin scaffold with biomimetic oriented microstructure using the directional crystallization technology, and to evaluate the possibility of application to the cartilage tissue engineering. Methods The silk fibroin scaffold with biomimetic oriented microstructure was made by the directional crystallization technology. The structure of scaffold was observed by the scanning electron microscope, and the pore size, porosity and mechanical properties were calculated. Adipose-derived stem cells were isolated from rabbit, and the passage 3 was seeded into the scaffold. The cell proliferation was detected by CCK8 method. The cell adhesion ability was observed by HE staining and scanning electron microscope. The cell viability was observed by LIVE/DEAD staining. Results The scanning electron microscopy showed that the parallel microtubule-like structure can be seen arranged in longitudinal section of the scaffold, which had a uniform directivity, and also the elliptical or circular pore structure in cross-section. The scaffold had a good pore interconnectivity with (112.43±12.65) μm pore diameter of the cross-section, (90.25±2.05)%porosity and (52.48±5.78) kPa the compression modulus. HE staining and scanning electron microscopy demonstrated that the cells uniformly adhered to the surface and inner pore, and which secreted lots extracellular matrix distributed in the oriented microstructure. Results of CCK8 showed that the good cell proliferation on the scaffold, and the LIVE/DEAD staining indicated that the cells were maintained good viability. Conclusion The silk fibroin scaffolds have a biomimetic oriented microstructure, and show good pore diameter, porosity, biocompatibility and biomechanical properties, which made it a suitable candidate as an alternative scaffold for cartilage tissue engineering.

ObjetiveTo investigate the obstetrical and neonatal outcomes of pregnant women with hypothyroidism or subclinical hypothyroidism.MethodsOne hundred and sixty-eight pregnant women with clinical or subclinical hypothyroidism during pregnancy,including 9 controlled hypothyroidism,29 uncontrolled hypothyroidism and 130 subclinical hypothyroidism,were enrolled in this study.The general clinical information,obstetrical complications and neonatal outcomes of these pregnant women were compared with that of 180 healthy pregnant women who delivered during the same period.ResultsCompared with control group,there were no significant differences in the levels of serum free triiodothyronine( FT3 ),free thyroxine ( FT4 ),thyrotropin-stimulating hormone (TSH) in the controlled hypothyroidism group in the third trimester [(3.68 ±1.11 ) pmol/L vs (3.19 ±0.33) pmol/L,(15.48 ±4.14) pmoL/L vs (13.95 ± 1.68) pmol/L,1.87 mU/L vs 1.76 mU/L,P ＞0.05].However,in the second and third trimester,the levels of FT3,FT4 in the uncontrolled hypothyroidism group were lower,while the levels of TSH were higher than in control group [(2.71 ±0.80) pmol/L vs (3.14 ± 0.34) pmoL/L,(10.94 ± 2.68) pmol/L vs (14.25 ±2.01) pmol/L,5.62 mU/L vs 2.28 mU/L,( 2.34 ± 0.70 ) pmol/L vs ( 3.19 ± 0.33 ) pmol/L,( 10.16 ± 1.65 ) pmol/L vs (13.95 ± 1.68) pmoL/L,7.13 mU/L vs 1.76 mU/L,t =2.754～9.15,P ＜0.01],the levels of TSH in the subclinical hypothyroidism were higher than in control group ( t =18.28,18.57,P ＜0.01 ).There was no adverse perinatal outcome of neonate happened in controlled hypothyroidism group.In contrast,the incidences of adverse perinatal outcomes and complications in the uncontrolled hypothyroidism group were higher than that in the control group ( 17.2％ vs 2.8％,37.9％ vs 5.6％,x2 =11.47,28.97,P ＜0.01 ).Compared with that of control group,the incidences of adverse obstetrical outcomes in pregnant women with subclinical hypothyroidism were increased (40.0％ vs 5.6％,x2 =52.97,P ＜ 0.01 ).ConclusionsThe rate of adverse obstetrical outcomes and complications is increased in women with clinical or subclinical hypothyroidism.But the incidence of adverse outcomes would decrease if hypothyroidism is controlled by treatment.

The drug-loading system of DMF (dextran - magnetic layered double hydroxide - fluorouracil) was synthesized by "co-precipitation intercalated assembly - dextran composite in situ - solvent conversion" technology. The crystal-phase characteristic and slow-release performance of DMF were investigated through X-ray diffraction (XRD), infrared spectrum (IR), transmission electron microscopy (TEM), thermogravimetry (TG) and in vitro release experiment. The targeted transshipment and slow-release effect of DMF system were evaluated by in vivo animal experiment. It was showed that the XRD of DMF matched with R-sixtetragonum type layered double hydroxide and Fd-3m cubic type ferrite. IR test demonstrated that the DMF system was a supra-molecular complex consisted of Dextran (DET), magnetic layered double hydroxide (MLDH) and fluorouracil (FU) components. The two-level supra-molecular MLDH-FU presented six-edge lozenge TEM morphology, with layered characteristics. DET on the surface of DMF was capable of protecting the layered structure of MLDH-FU, improving particle dispersion properties, and strengthening the slow-release performance of the drug delivery system. The drug release model of DMF at pH 7.35 of PBS in vitro fit to the zero-order kinetics equation C = 1.1716 x 10(-5) + 4.4626 x 10(-7) t. The drug delivery system DMF could transport drugs principally to in vivo target organs with a local effect, targeted specificity, and excellent circulation transshipment performance. The pharmacokinetic process of DMF presented multi-peak phenomenon with peak attenuation and cyclic growth. The peaks appeared at 0.25, 1, 3, 5 and 9 d separately after dosing intervention. The first peak process of DMF accorded with a pharmacokinetic equation of C(FU) = 14.34 e(-0.530t) + 36.04 e(-0.321t) + 24.18 e(-0.96t), and presented the characteristic of slow absorption and fast elimination. As for subsequent peak processes, half-life increased, bioavailability increased, and plasma clearance decreased. The highest peak value of DMF was 1/37 of original value of FU, and the relative bioavailability was 419% to original FU.