Objective To investigate the effects of duration of active phase on delivery mode and pregnancy outcome.Methods Data of 417 women with abnormal active phase identified from 1744 term-birth,singleton,cephalic presentation primiparas who had tried vaginal delivery in Peking University First Hospital from January 1,2009 to December 31,2009 were retrospectively studied.Effects of different durations of protracted active phase on pregnancy outcomes were compared between women with vaginal delivery or cesarean section by Chi square test.Results The incidence of protracted active phase was 23.9％ (417/1744); and the incidence of prolonged active phase was 2.9％ (50/1744).There were 205 cases of cesarean section and 212 cases of vaginal deliveries.The incidence of neonates hospitalization in Department of Pediatrics in vaginal delivery group with active phase ≥6 h was higher than that of those with active phase ＜6 h [20.6％ (26/126) vs 8.1％ (7/86),x2 =6.07,P＜0.05].The incidence of intrauterine infection in cesarean section group with active phase ＜6 h were higher than that of those with active phase ≥6 h [22.7％ (30/132) vs 6.8％(5/73),x2 =8.37,P＜0.01].In vaginal group with protracted active phase before 6 cm of cervical dilation,the incidences of postpartum hemorrhage (4.8％,9/186),maternal complications (3.8％,7/186) and neonates hospitalization (15.6％,29/186) were similar with those after 6 cm of cervical dilation [6.2％ (1/16),x2=0.12; 0.0％ (0/16),x2=0.01 and 12.5％ (2/16),x2=0.00; all P＞0.05] respectively.In cesarean delivery group with cervical dilation ≥6 cm,the incidence of neonates hospitalization was higher than that of those with cervical dilation ＜6 cm [60.0％ (6/10) vs 19.9％ (34/171),x2 =8.83,P＜0.05].There were no difference in maternal age,gestational age,body mass index at delivery,volume of postpartum hemorrhage and neonatal birth weight between women with cesarean section whose protracted active phase ≥4 h or ＜4 h when cervical dilation at 3 cm (P＞ 0.05 respectively).The incidence of neonates hospitalization was low in women whose indication of cesarean section was protracted active phase (11.2％,9/80),while it was high when protracted active phase complicated with intrauterine infection (42.1％,16/38).Conclusions Protracted active phase with cervical dilation less than 6 cm might not need active management if neither the mother nor the fetus is compromised.The infants born vaginally should be closely monitored if the active phase is over 6 h.

Objective To observe the effects of rehabilitation in the 55 prelingually deaf pediatric cases for two years after cochlear implantation ,factors including cochlear implantation and recovery time ;to compare the re-covery effects in the group of 1 to 3 years old children with the group of 3~5 years old (including the age of 3 years old) who lost their hearing before learning to speak ,and to provide clinical evidence for providing cochlear implant therapy to the prelingually deaf children as early as possible .Methods A total of 55 pediatric relingually deaf cases were included in this study .According to their implantation time and application duration ,they were divided into 2 groups :1 to 3 years old group (32 cases) ,and >3 to 5 years old group (23 cases) respectively .The hearing ,lan-guage and learning abilities on 1 ,3 ,6 ,12 ,18 ,24 months after cochlear implantation were evaluated ,using statisti-cal method to record CAP and SIR scores .Results The rehabilitation effects ,the average ages ,CAP ,speech rec-ognition rates and SIR were increased two years afterwards .The effects of younger age group were more noticeable than that in the older group .The differences between the two groups were statistically significant (P<0 .05) .Av-erage speech recognition rates ,average speech rehabilitation effects in each postoperative period of younger age group were better than those of in older age group ,showing significant differences (P<0 .05);CAPs in the younger age group on 1 ,3 and 12 months after CI surgery were significantly higher than those of in the older group (P value were 0 .001 ,0 .001 and 0 .002 ,respectively) .SIR in the younger age group at the time of 1 ,3 ,12 ,24 months were significantly higher than those of in the older group(P values were 0 .00 ,0 .00 ,0 .00 and 0 .024 ,respectively) . Conclusion Implanted age and recovery time are the key factors that influence the effects of postoperative rehabilita-tion .The younger when the children get cochlear implantation and the longer the recovery time takes during two years after cochlear implantation ,the better the results are .The standardization of domestic assessment for the re-covery effects and the international evaluation method have a certain degree of equivalence .

Basal Ganglia Diseases ; chemically induced ; therapy ; Child ; Humans ; Lamivudine ; adverse effects ; Male ; Palliative Care ; Reverse Transcriptase Inhibitors ; adverse effects ; Treatment Outcome

Objective To explore whether dynamic contrast-enhanced MRA (DCE MRA) can provide an effective assessment of renal vascular in living donors before transplantation.Methods Thirty five healthy living renal donor candidates were scanned on MR system before transplantation.After injection of Gd-DTPA 1 ml in vein, a test-bolus scan was used to get the time delay of Gd-DTPA reaching renal artery.Then, a 3D T1-weighted fast low-angle shot sequence (3D FLASH) was performed in the coronal plane.The 3D FLASH scan would repeat four times with an inter-phase of 10 seconds.Thus, the imaging of the renal arterial, venous and collecting systems were got.Two radiologists observed renal arteries and veins on original imaging and MIP reconstructed imaging.The quality of MR angiography was evaluated on a fivepoint scale and the vascular anatomy or variations of the arterial and venous systems were recorded, using intraoperative findings as a standard of reference.Results The quality for all MRA was good or very good for the most of living renal donors.Among 70 renals, several variations of vascular were found, including 5 left accessory artery, 9 right accessory artery, 3 left proximal arterial branch and 6 right proximal arterial branch.Among 70 renal veins, 1 right accessory veins and 2 left varieocele were observed.One small accessory artery of right kidney was missed with DCE MRA, but identified by operation.Conclusion DCE MRA was noninvasive tool for evaluation of the renal vasculature and variations with high accuracy.It would be a good modality in preoperative evaluation of living renal donors.

Objective To investigate the effects of sevoflurane postconditioning on cardiomyocyte apoptosis during myocardial ischemia-repeffusion (I/R) in rats.Methods Forty-five healthy male Wistar rats weighing 250-280 g were randomly divided into 3 groups ( n =15 each):group sham operation ( group S) ; group I/R and group sevoflurane postconditioning (group Spo).The animals were anesthetized with intraperitoneal 3％ pentobarbital 45 mg/kg,tracheally intubated and mechanically ventilated.Myocardial I/R was produced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion in groups I/R and Spo.In group Spo the animals inhaled 2.5％ sevoflurane for 5 min starting from 1 min before reperfusion was started.The animals were sacrificed at the end of 120 min reperfusion.Their hearts were removed for measurement of infarct size and the area at risk and determination of apoptotic index (the number of apoptotic cells/the total number of cells) and Bcl-2 and Bax protein and mRNA expression.Results Sevoflurane postconditioning significantly reduced infarct size in group Spo as compared with group I/R.There was no significant difference in area at risk between groups I/R and Spo.Myocardial I/R significantly increased the apoptotic index,Bcl-2 and Bax protein and mRNA expression in group I/R as compared with group S.Sevoflurane postconditioning significantly decreased apoptotic index and Bax protein and mRNA expression but increased Bcl-2 protein and mRNA expression in group Spo as compared with group I/R.Conclusion Sevoflurane postconditioning attenuates myocardial I/R injury by redncing myocardial apoptosis,up-regulating Bcl-2 expression and down-regulating Bax expression.

BACKGROUND: Human allogenic acellular dermal matrix, as a kind of permanent dermal scaffold, has widely used in the fields of burn wound reparation and aesthetic medicine. However, it is limited due to insufficient resources. OBJECTIVE: To prepare porcine acellular dermal matrix (PADM) dermal matrix, in addition, to estimate its in vitro biocompatibility. DESIGN, TIME AND SETTING: An in vitro cytology contrast experiment. The Experiment was performed at the laboratory of Biomaterials and Pharmacy Technology Institute, China Institute for Radiation Protection between August 2007 and June 2008. MATERIALS: The experiment pigs were supplied by experimental animal center of China Institute for Radiation Protection. Human fibroblasts were obtained from prepuce tissues of healthy children who underwent circumcision at the Shanxi Provincial General Hospital, Chinese People's Armed Police Forces. METHODS: The PADM was prepared from porcine skin by removing epidermis with a hypertonic salt solution and excluding cellular components in dermis with sodium dodecyl sulfate, and trypsin in hypersonic conditions. Human fibroblasts were cultured in vitro, and the biocompatibility of PADM was estimated with MTT method and contact method. MAIN OUTCOME MEASURES: ①Histological morphology of PADM. ②In vitro biocompatibility of PADM. RESULTS: The prepared PADM was a kind of matrix with normal structure and organization of collagen without epidermis and any cellular components in the dermis. The extraction of the porcine acellular dermal matrix had no effect on proliferation of the cultured human fibroblast. The cultured human fibroblasts could attach and proliferate on PADM. CONCLUSION: The PADM effectively removed epidermis and all cellular components with excellent biocompatibility can be obtained by this preparation method.

To investigate the metabolic rate and metabolites of 9-dehydro-17-dehydro-andrographolide, which is the main active ingredient in Xiyanping injection, by using the in vitro rat liver microsome incubation system. 9-dehydro-17-dehydro-andrographolide was incubated together with liver microsome mixed with NADPH. Its metabolic rate was studied by determining its residual concentrations with the UHPLC-MS/MS method; Its metabolites were identified by the UPLC-TOF-MS(E) method. The results showed that 9-dehydro-17-dehydro-andrographolide was metabolized faster than rat liver microsomes mixed with coenzymes, with t½ and CL of (19.7 ± 0.5) min and (35.1 ± 0.8) mL x min(-1) x g(-1) (protein), respectively. Based on the high resolution mass spectrum data and information from literatures, altogether nine metabolites of 9-dehydro-17-dehydro-andrographolide were identified in the incubation system, particularly hydroxylated and dehydrogenized products. The results of identification would provide a basis for screening out more active andrographolide derivatives.
Animals ; Chromatography, High Pressure Liquid ; Diterpenes ; chemistry ; metabolism ; Drugs, Chinese Herbal ; chemistry ; metabolism ; Microsomes, Liver ; chemistry ; metabolism ; Molecular Structure ; Rats ; Tandem Mass Spectrometry

Objective To learn from various view points the team building of rural doctors in Beijing.Methods 84 village officials,rural doctors and villagers were enrolled from three townships in district H of Beijing,for an interview to learn the makeup and selection approach of rural doctors,and their recommendations on team building of these doctors.Results 76.19% of the interviewees prefer their own villagers as candidates for their rural doctor.Top three factors for their retention were their medical competence,geo-relations,and service attitude;60.71% of the interviewees held that the village committee should be the decision maker for appointment of rural doctors; in terms of team building,senior doctors emphasize retirement conditions,while new ones prefer training opportunities.Conclusions The topmost criterion for rural doctor candidates should be their medical competence,instead of sacrificing this criterion for geo-relations.The village committee and the villagers' congress should play a greater role of supervision and management of the rural doctors.Targeted incentives are recommended for the rural doctors in view of their retention.

AIM:To study the influence of stimulation by LPS and CD40 ligandization in vitro on the TLR4-MD2 expression and IL-12 production in dendritic cells (DCs) modified by sCD40 gene and provide the experimental clues of inducing dornor-specific immune tolerance.METHODS: Plasmid pEGFP-N1/sCD40 and pEGFP-N1 was transfected into DC2.4 cell line with lipofectamine. After 6 h of treatment with LPS and anti-CD40mAb, the expression of TLR4-MD2 on DCs was determined with flow cytometry (FCM) and RT-PCR. IL-12p70 protein was detected by ELISA.RESULTS: LPS treatment of DCs down-regulated surface expression of TLR4-MD2, LPS treatment along with anti-CD40mAb significantly up-regulated TLR4-MD2 surface expression. CD40 ligandization did not affect TLR4-MD2 mRNA expression in DCs but partly increased its low level induced by LPS and markly enhanced IL-12p70 secretion after LPS stimulation. DCs modified by sCD40 gene inhibited the above effect.CONCLUSION: After treatment with LPS and anti-CD40mAb, DCs modified by sCD40 gene down-regulate surface expression of TLR4-MD2 and IL-12p70 secretion decreases significantly, which might be linked with the interruption of TLR4-MD2 transportation from cytoplasm.

AIM:To evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment 6, 12 and 18mo with blood oxygenation level dependent - function magnetic resonance imaging techniques ( BOLD-fMRI) .
METHODS: In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children which was the first phase of research for amblyopic treatment. Functional MRI data were processed by using SPM8 which based on the Matlab 7. 12. 0. 635. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test.
RESULTS: The functional area that was left occipital lobe (BA18), middle occipital gyrus (BA19), limbic lobe (BA19), lingualis gyrus of the right occipital lobe (BA17) and the bilateral parietal lobe ( BA7 ) expanded after amblyopia treatment 6, 12mo, compared those treatment phase, mean t value was 1. 5762, 1. 6856 respectively (P<0. 001). However, the difference of activated intensity was lower after 18mo, mean t value was 1. 1473 (0. 001 CONCLUSION: In children anisometropic amblyopia, the speed of function reconstruction about visual cortical functional mediating stereopsis increase slowly after amblyopia treatment 1a.