ObjectiveTo summarize the clinical significance of ultrasonic screening of fetal structural anomalies at 11-13+6 weeks.Methods We conducted a retrospective study of 4853 cases of nuchal translucency screening at 11-13+6 weeks in Maternal and Child Health Hospital of Bao?an of Shenzhen City from September 2011 to May 2014. The screening ultrasound planes included the median sagittal plane, neck sagittal section, cerebral transverse section, cardiac four-chamber view, three-vessel-trachea view, abdominal transverse section, bladder section, upper limb section and lower limb section of the fetuses. All the cases then underwent the ultrasonic structural screening in the second trimester (20-24 weeks) and the third (28-32 weeks) trimester and were followed up until 6 weeks after birth or the biopsy after abortion.Results Eighty-ifve fetal structural anomalies were detected among the 4853 pregnant women at 11-13+6 weeks of gestation with the detection rate of 1.75% (85/4853), including central nervous system abnormalities (28 cases), anterior abdominal wall anomalies (9 cases), cardiac anomalies (6 cases), urinary system malformation (3 cases), skeletal system malformation (2 cases), multilocular cystic tumor and dropsy embryo (35 cases), and abnormal twins (2 cases). Among above abnormal fetuses, 6 cases showed normal structure in the screening after 14 weeks and were born without malformations, while the rest 79 cases were taken artiifcial abortion (73 cases in the ifrst trimester and 6 cases in the second trimester). Only 9 cases were taken chorionic puncture or amniocentesis, including normal karyotypes (3 cases), 47, XN, +18 (3 cases) and 45, X (3 cases). The False negative rate in the ifrst trimester was 23% (25/110). Supplementary detection of fetal structural abnormalities in the second and third trimester were found in 22 cases (20%, 22/110). Two cases of VSD and 1 case of microtia were identiifed after birth.ConclusionsThe fetal malformation can be detected in the earlier gestation with the ultrasonic screening at 11-13+6 weeks, which provide the earlier termination to the abnormal fetus. It has important clinical signiifcance in effectively reducing fetal births with structural abnormalities.

Abstract?AIM: To compare the changes in epithelial thickness profile following TransPRK and Epi-LASIK for myopia.? METHODS: In this prospective non -randomized controlled study, 76 right eyes of 76 myopic patients with the spherical equivalent refraction -1.25 to -6.00D were included under the informed consent. The eyes were divided into TransPRK group for 43 eyes and Epi-LASIK group for 33 eyes. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones ( central, 2mm; paracentral, 2-5mm;and mid-peripheral, 5-6mm) preoperatively and at 1, 3, and 6mo postoperatively. The results were compared between the two groups.?RESULTS: The epithelium were thicker at 3 and 6mo after surgery compared to preoperative measurements in the two groups (all P<0.05).In TransPRK group, the epithelial thickness at 3 and 6mo demonstrated a negative meniscus-like lenticular pattern with lesser thickening centrally and progressively great thickening centrifugally (F3mo =-2.687,P=0.027;F6mo =-2.908,P=0.000).No statistically significant change was detected among the three zones in Epi-LASIK group (F=1.365, P=0.237). The epithelial thickness was thicker in the TransPRK group compared to the Epi-LASIK group mid-peripherally ( P<0.05) .? CONCLUSION: Significant epithelial thickening was observed after TransPRK and Epi-LASIK.It was showed a lenticular change with more thickening mid-peripherally after TransPRK than Epi -LASIK. Wound healing and inflammation may account for differences in the effect on epithelial thickness change by both surgeries.

Objective To retrospectively analyze the effect of corticosteroids therapy for inflammatory bowel disease (IBD) at 1-month and 1-year. Methods Those who was diagnosed as Crohn's disease (CD, n=55) or ulcerative colitis (UC, n= 154) from 1998 to 2006 were investigated. The effect of corticosteroids was evaluated after one month and 1-year. The prognostic factors were calculated using Logistic regression analysis. Results The patients who received eortieosteroids therapy were 21 (38.2%) with CD and 20 (13.0%) with UC (2 cases withdrawn). In one month followe-up, the complete and partial remissions were found in 15 (71.4%) and 3 (14.3%) patients with CD, respectively, while there were 15 (83.3%) and 3 (16.7%) in patients UC, respectively. Only 3 (14.3%) patients with CD was no response. In one year follow up, 11 out of 21 (52.4%) patients with CD had prolonged response to corticosteroids, 6 (28.6%) were corticosteroid dependence, and 4 (19%) required surgery; whereas 11 out of 18 (61.1%) patients with UC had prolonged response, 3 (16.7%) were corticosteroid dependence, and 4 (22.2%) required surgery. Logistic regression analysis showed that serum albumin level was associated with efficacy of corticosteroids after one year (P= 0.027, OR: 1.320,95% CI: 1.032~1. 690). Conclusion The IBD patients who has response to initiating corticosteroids therapy will get shor-term remission. Its prognosis is related with serum albumin level.

Objective: To study the influence of preoperative transcatheter arterial chemoembolization (TACE) by selection on survival rate of resectable hepatocellular carcinoma (HCC) patients. Methods: Jan. 1996 to Jan. 1997, TACE was performed before surgery in 62 of 126 patients undergoing resection and the other 64 patients without TACE from. Results were retrospectively analyzed with regard to the changes of pathological examination after operation, recurrence rate and survival rate 1, 2, 3 years after operation. Results: Pathological examination showed that there were 13 total necrosis in TACE group, but no one in contrast group. There were no significant difference of recurrence rate 1, 3 years after operation between 2 groups. Recurrence rate 2 years after operation was 29.8% in TACE group, but 58.3% in contrast group. There were significant difference of recurrence rate 2 years after operation between 2 groups (P<0.05). Survival rate 3 years after operation was 54.4% in TACE group, but 33.3% in contrast group. Survival rate of TACE group was higher than that of contrast group (P<0.05). There were not significant difference of recurrence rate 1, 2 years after operation between 2 groups. Conclusion: Proper preoperative TACE for resectable HCC can improve the outcome of the operation to some extent.

Animals ; Hepatocyte Growth Factor ; metabolism ; Humans ; Proto-Oncogene Proteins c-met ; Serine Endopeptidases

BACKGROUNDMutations of transthyretin (TTR) cause the most common type of autosomal-dominant hereditary systemic amyloidosis, which occurs worldwide. To date, more and more mutations in the TTR gene have been reported. Some variations in the clinical presentation are often observed in patients with the same mutation or the patients in the same family. The purpose of this study was to find out the clinicopathologic and genetic features of Chinese patients with hereditary TTR amyloidosis.

METHODSClinical and necessary examination materials were collected from nine patients of eight families with hereditary TTR amyloidosis at Peking University First Hospital from January 2007 to November 2014. Sural nerve biopsies were taken for eight patients and skin biopsies were taken in the calf/upper arm for two patients, for light and electron microscopy examination. The TTR genes from the nine patients were analyzed.

RESULTSThe onset age varied from 23 to 68 years. The main manifestations were paresthesia, proximal and/or distal weakness, autonomic dysfunction, cardiomyopathy, vitreous opacity, hearing loss, and glossohypertrophia. Nerve biopsy demonstrated severe loss of myelinated fibers in seven cases and amyloid deposits in three. One patient had skin amyloid deposits which were revealed from electron microscopic examination. Genetic analysis showed six kinds of mutations of TTR gene, including Val30Met, Phe33Leu, Ala36Pro, Val30Ala, Phe33Val, and Glu42Gly in exon 2.

CONCLUSIONSSince the pathological examinations of sural nerve were negative for amyloid deposition in most patients, the screening for TTR mutations should be performed in all the adult patients, who are clinically suspected with hereditary TTR amyloidosis.

Adult ; Aged ; Aged, 80 and over ; Amyloid Neuropathies, Familial ; diagnosis ; genetics ; Asian Continental Ancestry Group ; Female ; Humans ; Male ; Middle Aged ; Mutation ; genetics ; Pedigree ; Prealbumin ; genetics

OBJECTIVETo investigate the effect of AMPK agonist 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR) on proliferation, differentiation and apoptosis of U937 cells and explore its possible mechanism.

METHODSU937 cells were cultured with different concentrations of AICAR for 24 h and 48 h. Cell proliferation was evaluated. Cell growth curve was analyzed by CCK-8; cell apoptosis was analyzed by cell morphology, Annexin V/7-AAD double labeling. The differentiation of U937 cells was evaluated by expression of CD11b. The Bcl-xL, Bax, Bim, caspase-3 mRNA expressions of U937 cells were determined by real time PCR.

RESULTSAICAR significantly inhibited the growth of U937 cells in a time-and dose-dependent manner, with a 24 h IC50 value of 1.1 mmol/L and 48 h of 0.9 mmol/L. 1.0 mmol/L AICAR didn't induce differentiation of U937 cells with the increase of CD11b expression for 24 h (P > 0.05). The U937 cells apoptosis was confirmed by cell morphology and Annexin V/7-AAD labeling. AICAR induced apoptosis of U937 cells and the apoptosis rate was (6.81 ± 1.16)% at 1 mmol/L AICAR higher than control group (2.74 ± 0.32)% without AICAR for 24 h treatment (P < 0.05). The real time PCR assay revealed that as compared with control group, the expression of Bim and caspase-3 mRNA were increased, while Bcl-xL and Bax were unchanged on the AICAR treatment.

CONCLUSIONAICAR can effectively inhibit proliferation and induce apoptosis of U937 cells. However, it has no significant effect on differentiation of U937 cells. The mechanism may be related with up-regulating Bim and Caspase-3.

Aminoimidazole Carboxamide ; analogs & derivatives ; pharmacology ; Apoptosis ; drug effects ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Humans ; Ribonucleotides ; pharmacology ; U937 Cells

Objective The left ventricular myocardial strain of acute myocardial infarction on cardiac magnetic resonance cine imaging was measured by feature tracking technique. The relationship between left ventricular myocardial strain and the transmural extent of Myocardial Infarction was evaluated. Methods 74 patients with acute ST segment elevation myocardial infarction were included. All theses patients received primary PCI within 12 hours. After 2 to 5 days. ECG gated steady-state free precession sequences were collected. Gadolinium contrast enhanced imaging was performed on short axis. 20 patients repeated same scan after 3 to 5 months. TomTec 2D CPA and Segment software were used to analyze the images. The peak values of the regional myocardial strain indexes. The transmural extent of myocardial infarction of segment in left ventricular was measured. Results There was no significant difference of longitudinal strain in non-infarction,non-transmural infarction and transmural infarction segments at the basal and middle segments. The circumferential strain peak and the radial strain peak of non-transmural infarction segments were lower than those of the non-infarction segments. The circumferential strain of transmural infarction segments were the lowest(basal level:-14.24％±9.05％,P<0.05;middle level:-12.71％±8.92％,P<0.05;apical level:-13.81％±11.13％, P<0.05). GLS was improved while LVDd was increased when compared the acute phase of myocardial infarction to that of 3-5 months after primary PCI. The circumferential strain and longitudinal strain of the non-transmural infarction segments was improved. The circumferential strain and radial strain of the transmural infarction segments 3-5 months later was improved as compared to the acute phase. Conclusions There was differences in myocardial strain in non-infarction,non-transmural infarction and transmural infarction segments from patients with acute ST segment elevation myocardial infarction who had accepted primary PCI. The circumferential strain and longitudinal strain of the non-transmural infarction segments were improved after 3-5 months. The circumferential strain and radial strain of the transmural infarction segments after 3-5 months was improved as compared to the acute phase. Cardiac Magnetic resonance could combine feature tracking technique with gadolinium contrast delayed enhancement technique,giving both function and tissue characteristic evaluation to the myocardial damages after acute myocardial infarction.

OBJECTIVETo investigate the distribution and expression of corticotropin releasing factor (CRF) in spinal cord, hypothalamus and third ventricle of cerebrum, of the hypersensitive viscera rats, and to research on the mechanism of CRF in the hypersensitive vicera signal conduction pathway in IBS (irritable bowel syndrome) and to investigate possible active mechanisms of tongxie prescription on IBS.

METHODForty SD rats were divided randomly into three groups. The rats of model No. 1 were sensitized by injecting egg albumin into abdominal cavity. The rats of model No. 2 were sensitised by conditional stimulus and unconditional stimulus. The two model groups were both divided randomly into two groups. The five groups were given intragastric administration with Tongxie prescription or normal saline for four weeks. Then quantitative analysis of CRF in the lumbosacral spinal cord and brain of rats were achieved by immunohistochemical method and computerized image system.

RESULTThe sensitivity of the groups being treated with tongxie prescription were much lower than the model groups (P < 0.01). The immunohistochemical method showed that CRF was expressed in the lumbar intumescentia of spinal cord, hypothalamus and the diaphragmatic surface of third ventricle of cerebrum. The CRF positive index of the model groups was higher than that of the blank group (P < 0.01). The CRF positive index of the healing groups was lower than that of the model groups (P < 0.01). The CRF positive index of the healing groups was higher than that of the blank group (P < 0.01).

CONCLUSIONThe two model rats evoked by two different stimulation both appeared visceral hypersensitivity state. CRF is related to stress. The increase of CRF expression in the lumbar intumescentia of spinal cord, hypothalamus and the diaphragmatic surface of third ventricle of cerebrum showed that CRF is critical to the introduce of stimulus signal of vicera. Tongxie prescription can significantly decrease CRF expression. This is one mechanism to decrease sensitivity of hypersensitive viscera rats.

Animals ; Brain ; drug effects ; metabolism ; Cerebral Ventricles ; drug effects ; metabolism ; Corticotropin-Releasing Hormone ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Gene Expression ; drug effects ; Humans ; Irritable Bowel Syndrome ; drug therapy ; genetics ; metabolism ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects ; Spinal Cord ; drug effects ; metabolism

OBJECTIVETo investigate the role of activated hepatocyte growth factor (HGF) in apoptosis of hepatic stellate cells (HSCs) and in modulating the Rho signaling pathway.

METHODSHSCs were divided into the following groups: blank control, consisting of HSCs without treatment; two treatment controls, consisting of HSCs exposed to exogenous HGF at 50 ng/ml and HSCs exposed to exogenous HGF activator (HGFA) at 70 ng/ml; three experimental groups, consisting of HSCs exposed to both exogenous HGF and HGFA, HSCs pre-incubated with the HGF inhibitor c-met at 500 ng/ml for 6 hours and then exposed to exogenous HGF and HGFA, and HSCs pre-incubated with the Rho pathway inhibitor Y-27632 at 10 ng/ml and then exposed to exogenous HGF and HGFA. Activation status of the cultured HSCs was determined by change in expression of alpha-smooth muscle actin (SMA). The optimal intervention concentration of Y-27632 was determined by MTT assay. The apoptotic status of HSCs was determined by flow cytometry. Expression of the HGF-alpha chain was detected by immunofluorescence. The expression of RhoA was evaluated by PCR (for mRNA) and by immunohistochemical staining and Western blot analysis (for protein).

RESULTSExposure to 10 mumol/L Y-27632 led to obvious growth inhibition of HGF + HGFA-induced HSCs, compared with the other concentrations tested (P less than 0.05). HGF + HGFA induced the expression of the HGF-alpha chain in a time-dependent manner (P less than 0.01); however, the increases in expression of HGF-alpha chain induced by HGF alone and HGFA alone were not significantly different from the level in the blank controls (P more than 0.05). Exposure to HGF alone and HGFA alone led to a time-dependent increase in apoptosis (24 h, 48 h, 72 h) but exposure to HGF + HGFA led to the highest levels of apoptosis (P less than 0.05). Exposure to HGF + HGFA led to a time-dependent decrease in RhoA mRNA and protein expression (P less than 0.01).

CONCLUSIONActivation of hepatocyte growth factor promotes apoptosis of hepatic stellate cells by suppressing RhoA expression and down-regulating the Rho signaling pathway.