ObjectiveTo explore ultrasonographic featurs of nuchal skin of normal fetus in its thickness and changes.MethodsThe thickness of nuchal skin of 900 normal fetal was measured by abdominal ultrasound with 7.5 MHz probe.ResultsThe nuchal skin only displayed whole layer before pregnant 27 weeks. After pregnant 27 weeks, the derma and subderma layer was distinguishable, the whole thickness of nuchal skin was ( 1.18 ? 0.05 )mm (10 weeks) to ( 6.01 ? 0.46 )mm (40 weeks) in normal fetus. All layers of nuchal skin were increased proportionally with gestation [r= 0.973 (whole layer), P 0.05 ).Conclusions The abnomal chromosome of fetus could be sifted by the thickness of nuchal skin and the character of sonographic image. It′s a useful diagnostic method for eugenics.

Objective TO study the effect of trimetazidine on patients with unstable angina pectoris. Methods The pa-tients with unstable anglna pectoris with routine treatment were divided randomly into trimetazidine group(T) and nitro-glycerin group(N). They were given such treatment two weeks. Results There is decreased incidence of angina pectorisand less amount of nitroglycerin consumption in both groups. compared with before. There was no significant difference be-tween the two groups. Conclusion There are no signficantly. Trimetazidine has a definite effect in treating unstable angi-na pectoris,and it is similar to nitroglycerin in effects.

Objective To compare the correlation between ACCP, IgA-RF, IgG-RF, IgM-RF and disease activity, bone erosion of rheumatoid arthritis. Method The correlation analysis between ACCP, IgA-RF, IgG-RF, IgM-RF and disease activity score (DAS), Ritchie′s articular index (RAI) were made SPSS software. ACCP, IgA-RF, IgG-RF, IgM-RF were compared between patients with erosive disease and with non-erosive disease. Results IgM-RF was associated with RAI, but ACCP, IgA-RF and IgG-RF were not associated with RAI. The above parameters were not associated with DAS by Spearman correlation analysis. The association between above parameters and bone erosion was not detected, however. Conclusion IgM-RF is associated with disease activity. ACCP and IgA-RF, IgG-RF are not associated with disease activity. No association is found between above parameters and bone erosion.

Objective To construct eukaryotic expression vector of HPV18 L1- E6, E7 chimeric gene and examine the humoral and cellular immune responses induced by this DNA vaccines in mice. Methods The C-terminal of major capsid protein L1 gene and mutant zinc finger domains of early E6/7 oncogenes in HPV18 were integrated and inserted into eukaryotic expression vector pVAX1 to generate vaccines pVAX1-L1E6Mxx, E7Mxx. CHO cells were transiently transfected with the individual construct. Target protein expressions in the lysate of the transfected cells were measured by ELISA and immunocytochemistry. After BALB/c mice were vaccinated with various recombinant plasmids(pVAX1-L1-E6M3 or pVAX1-L1-E7M3) and immunie adjuvants (pLXHDmB7-2 or LTB) through different administration routes (intramuscular or intranasal) , the great cellular immune responses were produced as revealed by delayed-type hypersensitivity (DTH) and lymphocyte proliferation, and the expression of IL-4 and IFN- γ cells in CD4+ and CD8+subpopulations. Results The highly efficient expression of pVAX1-L1E6Mxx, E7Mxx vector in host eukaryotic cells were demonstrated both by ELISA and immunocytochemistry. The level of specific serum IgG against HPV in experiment groups mice was much higher than that of control group, and intranuscular immunization group had the highest antibody level. Intramuscular immunization groups were superior to intranasal immunization groups in DTH response, splenocyte proliferation and CD8+ IFN-γ + cells number, but CD4+ IL4+ cell number was higher in intranasal immunization groups. The immunization groups using pLXHDmB7-2 as adjuvant were superior to other groups in immunoresponse. Conclusion These DNA vaccines produce remarkable cellular and humoral immuneresponses in the mouse and may provide as prophylatic and therapeutic candidates for HPV induced cancer treatment.

AIM: To study the effects of protein kinase C on the expression of MMPs that may play an important role in the formation of atherosclerosis and the possible mechanism of Danshen injection to treat atherosclerosis. METHODS: 50 Sprgue-Dawley (SD) rats were divided into three groups randomly: control group (group C), model group (group M) and Denshen treatment group (group D). The serum was collected to measure the level of cholesterol, triglyceride, low density lipoprotein cholesterol(LDL-ch). The expression of PKC and MMPs were measured by immunohistochemistry. Light microscope and electron microscope were also used. RESULTS: ① The cholesterol, triglyceride, LDL-ch concentrations in group M and group D were significantly higher than those in group C (P

Objective:To investigate the effects of PDCA method on improving the accuracy of the Autar Deep Venous Thrombosis (DVT) Scale used by nurses to assess the risk of deep venous thrombosis in surgical patients.Methods:Applied the way of PDCA, namely, raising questions, analyzing reasons, implementing measures, feeding back effects to professional explanate the difficulty in using the scale, moreover, training the nurses used level education method between August 2017 and December2018.The accuracy and consistency of the scale were compared before and after interventions.Results:A total 396 patients were evaluated in the study. There were significant differences in the consistency of evaluation among hospitalized, post-operative and discharged patients after intervention compared with before intervention ( P< 0.0167).The consistency of assessment of team members and responsible nurses increased from 68 to 120 cases, and the consistency of assessment reached 90.91%. The Kappa consistency of assessment of responsible nurses and team members increased from 0.354 before intervention to 0.879 after intervention. The effect was remarkable. Conclusions:PDCA cycle method is based on the problems found in clinical practice. It clarifies the professional terms and rules used in the scale, improves the accuracy and consistency of the Autar DVT scale used by nurses, correctly reflects the risk of thrombosis, ensures the safety of patients, and is worthy of promotion and reference.

Objective To isolate bacteriophages against extensively-drug resistant Acinetobacter baumannii from hospital sewage and analyze their biological characteristics.Methods Extensively-drug resistant Acinetobacter baumannii isolated from several hospitals in Shanghai during December, 2013 to July, 2014 were used as host bacteria, adopting double-layer agar method to isolate bacteriophages from raw sewage of these hospitals.The phage with broad host range was selected for further study, including observation of electron microscopic morphology, examination of thermal stability, pH stability and the optimal MOI, drawing of the adsorption, one-step-growth and infection curves, as well as sequencing of the phage genome DNA. Results An extensively-drug resistant Acinetobacter baumannii bacteriophage vB_AbaP_PD-AB9 ( PD-AB9 for short) with broad host range was isolated, and electron microscopy revealed it belonged to Podoviridae family.The optimal MOI of PD-AB9 was 0.001.PD-AB9 remained stable among 4 ℃to 50 ℃and pH 4 to 11.In the adsorption experiment, the adsorption rate of PD-AB9 reached above 95%within 5 min.PD-AB9 had a latent period of 4 min and a burst size of 213.PD-AB9 could obviously restrain the host growth, with faster effect at the higher MOIs (MOI=1, 0.1, 0.01) than at the lower ones (MOI=0.001, 0.000 1).Furthermore, genome of PD-AB9 proved to be a double-stranded linear DNA with size of 40 938 bp and GC content of 39.34%.Conclusions PD-AB9 exhibits good thermal stability, wide pH tolerance range, very fast adsorption, a short latent period, a large burst size and it could quickly cause effective host lysis after infection.Therefore, PD-AB9 is promised to act as a new antimicrobial agent to control drug-resistant Acinetobacter baumannii infections and its bio information remains to be further studied.

Universal adhesives have been widely used in dentistry due to their easy application process and wide range of applications. In the literature, the etching modes of universal adhesives, coating methods of universal adhesives, pretreatment of adhesive, and other factors were reported to have an impact on the bonding performance of universal adhesives. This review focused on the factors affecting the bonding performance of universal adhesives and aimed to provide evidence-based recommendations for clinical practice. Current research suggests that the etch-and-rinse mode can achieve a better adhesive strength of enamel and that the etch-and-rinse mode and the self-etch mode exhibit a similar adhesive performance in bonding dentin. The bond strength would be improved by prolonging the application time, applying a double layer of adhesives, and wetting enamel and dentin with water or ethanol before adhesive procedures. Chlorohexidine (0.2%) and metal nanoparticles can inhibit matrix metalloproteinases (MMPs) and improve the long-term bond strength of dentin. Finally, universal adhesives have excellent stability and saliva pollution resistance, although they lack blood pollution resistance. In the clinic, dentists should pay attention to the etching modes of universal adhesives, coating methods of universal adhesives, pretreatment of adhesive, and other factors that may affect the effect strength. universal adhesives will be improved in bonding strength of enamel in self-etch mode and bonding performance in demineralized dentals around caries.

OBJECTIVESTo increase the diagnosis and treatment of ectopic ACTH syndrome.

METHODSThe data of 12 ectopic ACTH syndrome patients treated from 1985 to 1999 were retrospectively analyzed.

RESULTSTwelve patients were diagnosed as having ACTH syndrome by endocrinary test and primary tumors were ascertained by imaging examination. Follow-up from 7 months to 8 years showed 3 out of 5 patients with radical resection of primary tumor died. One patient with bilateral adrenorectomy was still alive. All patients received only chemotherapy except one died.

CONCLUSIONSPatients with Cushing's syndrome should be evaluated by endocrine test and followed up by imaging screen examination. The key points to increase treatment effect include early detection, localization and resection of primary tumors.

Objective To retrieve,assess and summarize the best evidence on breast milk expression of premature infants' mothers in maternal separation so as to provide high-quality evidence for medical staff to carry out breast feeding guide. Methods Guidelines,systematic reviews,recommended practices and evidence summaries were retrieved in the UpToDate,WHO,Academy of Breastfeeding Medicine(ABM), Cochrane Library,Joanna Briggs Institute Library,Registered Nurses' Association of Ontario(RNAO), National Guideline Clearinghouse(NGC),PubMed,Embase,Chinese Biological Medicine,Chinese National Knowledge Infrastructure,WanFang data,VIP and the evidence-based nursing database of Fudan University from January 2008 to December 2018. Results A total of 7 literatures were included,two guidelines,one clinical decision,two systematic reviews and two evidence summaries. A total of 19 evidences were gathered in 7 aspects,such as training for medical staff,parents' education,selection of breast pump,preparation before expression,operational skills of breast expression,measures for increasing lactation and expression effects monitor. Conclusions Clinical medical staff should lay down the individualized nursing measures for maternal women to ensure breast milk collected as soon as possible,gain enough breast milk and fill the bill of growth and development of premature infants.