Objective To discuss the clinical features of pregnant women with hypertrophic cardiomyopathy (HCM).Methods There were 28 patients with HCM who delivered in Renji hospital of Shanghai Jiaotong University from January 2000 to August 2012.Clinical data were analyzed,including diagnosis,cardiac functional grading,gestational weeks of delivery,delivery mode,birth weight,Apgar scores,etc.Results (1) Of all the 28 patients,14 (50％) were diaguosed before pregnancy and others (50％) were diagnosed during pregnancy.(2) Four cases were obstructive HCM (14％),3 with cardiac function grade Ⅰ and 1 with grade Ⅱ.Twenty four cases were non-obstructive HCM (86％),14 with cardiac function grade Ⅰ,9 with grade Ⅱ and 1 with grade Ⅳ.(3) Of all the 28 patients,4 had family history,18 (64％) had clinical symptoms or signs which occurred in 8-32 gestational weeks.Twenty-three cases had abnormal ECG (82％).Among them 21 had non-obstructive HCM (88％),with average interventricular septal thickness of(22 ± 3) mm.The other 2 patients had obstructive HCM,with average interventricular septal thickness of (23 ± 4) mm.7 patients (7/28,25 ％) had mild-to-moderate pulmonary hypertension [6 with non-obstructive HCM (6/24,25％)],and 10 patients had abnormal myocardial enzyme spectrum or troponin levels [9 with non-obstructive HCM (9/24,38％)].(4) Among all the patients,only one had vaginal delivery and others received cesarean section.Twenty-two patients had term pregnancies and 6 had preterm birth.The average gestational weeks of delivery in non-obstructive HCM and obstructive HCM were (36.5 ± 2.5) and (38.5 ± 0.4) weeks,respectively.The average birth weight of neonates were (2684 ± 563) and (3164 ± 321) g,and Apgar scores were 9.9 and 10 (10 minutes) respectively.Patients transferred to NICU after delivery were 8 and 0.There was 1 maternal death(with nonobstructive HCM whose ejection fraction was only 26％) and no perinatal death.Conclusions More attention should be paid to the clinical signs and abnormal ECG.HCM could be definitely diagnosed by timely echocardiography.Patients with hypertrophic cardiomyopathy were mainly non-obstructive HCM,with cardiac function grade Ⅰ and Ⅱ.Monitoring the change of ejection fraction during pregnancy would help.Perinatal outcomes were fine.

Objective To evaluate the synergy effect of Meropenem and Sulbactam combination against Meropenem-resistant and Meropenem-susceptible A.baumannii in vitro and optimize combination ratio of Meropenem and Sulbactam to achieve best synergy effect.Methods Evaluating the synergy effect of Meropenem and Sulbaetam combination through microdilution checkerboard method against Meropenemresistant and Meropenem-susceptible A.baumannii,isolated from inpatients of Chinese hospitals.Assessing the synergy effect of combination in different ratios of Meropenem to Sulbactam.Results The checkerboard method with the combination of Meropenem and Sulbactam demonstrated 25.0％ ( 10/40 ) synergism,67.5％ (28/40) partial synergism,7.5％ (3/40) additive,no indifference and antagonism in Meropenemsusceptible isolates,and 27.5％ (11/40) synergism,40.0％ (16/40) partial synergism,25.0％(10/40) additive,no indifference and antagonism in Meropenem-resistant isolates.Eleven Meropenemresistant isolates which showed synergism in synergy test were tested for MICs of combination of Meropenem and Sulbactam,using ratios of 4∶ 1,2∶ 1,1∶1 and 1∶2,and the MIC90 were 64∶ 16,64∶ 32,32∶32,32∶64 μg/ml,respectively.Conclusions Meropenem and Sulbactam combination show synergism or partial synergism against most A.baumannii isolates.The optimal ration of combination for clinical use may be 1∶ 1.

Objective Minimally invasive treatment of orthopedic diseases is the general direction of future development of medicine.This study was designed to observe the effect of manual reduction combined with percutaneous kyphoplasty (MR+PKP) in the treatment of fresh osteoporotic vertebral compression fractures ( OVCF) in elderly patients. Methods Sixty OVCF patients aged 60-86 ( mean 72.3) years were randomly assigned to 2 groups of e-qual number to be treated by MR+PKP and PKP alone, respectively. Comparisons were made between the two groups of patients in the op-eration time, volumeand permeability of the bone cement injected,changes of the Cobb angle,restoration of the anterior height of the compressed vertebral bodies,pre-and post-operative Visual Analogue Scale ( VAS) pain scores, OswestryDisability Indexes ( ODIs) , and other differences observed before and aftersurgery. Results Op-erations were performed successfully in all the 60 cases.In the MR+PKP group, the mean operation time was 61 min, the mean volume of bone cement injected was 5.1mL with qualified distribution, and bone cement leakage occurred in 1 case without adverse reaction. Statistically significant differences were found in the pre-and post-operativeanterior height of the compressed vertebral bodies, Cobb an-gle, VAS scores, and ODIs (P<0.05).Compared with the PKP control, MR+PKP achieved a significant increase at 3 days and 3 months after surgery in the anterior height of the compressed vertebral bodies ([22.4±1.4] vs [26.8±8.1] mm and [21.4±4.2] vs [26.5±7.2]mm, P<0.05), and a decrease in the Cobb angle ([8.6±2.7] vs [8.1±2.1]°and [9.0±2.3] vs [8.3±1.8]°, P<0.05) as well as remarkably reduced VAS scores (4.1±2.2vs 3.1±2.0, P<0.05)and ODIs (23.0±3.1vs25.6±3.3, P<0.05) at 3 d postopera-tively. Conclusion MR+PKP, with its advantages of effective pain-relief, improvement of the height of compressed vertebral bodies, and reduction of bone cement leakage,is better than PKP alone for the treatment of OVCF in elderly patients.

The process of lung cancer invasion and metastasis consists of a complex series of multigene and multistep, CD44V6 is a broadly distributed transmembrane glycoprotein, which mainly participates in the specific adhesion process and plays an important role in cell-cell and cell-matrix interactions.The researches showed that the high expression of CD44V6 was helpful for metastasis ability of tumor cell. MMps is a groups of metal hydronium depend-proteinase, it exhibits proteolytic activity against components of the extracellular matrix (ECM). The recent study indicated that MMps has been played important roles not only in degradation of ECM proteins, but also in the regulation of tumorigenesis. Combined with two marker might be an important significant to judge prognosis ,metastasis and development.

Objective To assess the left ventricular systolic asynchronicity in chronic ischemic model with real-time three-dimensional echocardiography (RT-3DE), and to explore the affection of low-dose dobutamine to it. Methods A chronic ischemic model was induced by placing an Ameroid constrictor in the left circumflex(LCX) in swines,then full volume RT-3DE was performed by Philips iE33 with X3-1 probe combining rest and stress(dobutamine stress echocardiography, DSE) every week after LCX constriction.Ten normal pigs before operation served as controls (group A). Examination of all the models post operation were grouped into group B (mild stenosis, LCX stenosis＜50% ), group C (moderate stenosis, LCX stenosis 50%～75%) and group D (severe stenosis, LCX stenosis≥75%) according to the results of coronary angiography. Images were copied to QLAB 5.2 postprocess workstation,and 3DQA software was used to analyze the full volume data sets. The time to the point with minimal systolic volume (Tmsv) in each segment was taken to derive the following indexes of systolic synchrony: the maximum difference of Tmsv (Tmsv-dif) and standard deviation(Tmsv-SD) among various segments and standard index (Tmsv-dif% and Tmsv-SD%), to evaluate left ventricular dyssynchrony. Tmsv3-6 represented the maximum difference of Tmsv between lateral segment and posterior septum (Tmsv3-5: between lateral segment and inferior) in basal level. Results Tmsvl2-Dif%, Tmsv6-Dif%, Tmsv3-6% and Tmsv3-5% under stress condition in group C and D were significantly higher than those at rest;all the data in group D were significantly higher than in group A and B, and in group C higher than group A ( P ＜0.05,0.01 ). Compared with group A,Tmsv6-Dif,Tmsv3-6 and Tmsv3-5 in group B were significantly increased under stress condition,and so did their standardize data under both rest and stress conditions ( P ＜ 0.05, 0. 01 ). Conclusions RT-3DEcombined with DSE could display sensitively the left ventricular asynchrony caused by chronic ischemia,and that will be more significant in lateral wall in LCX stenosis than in normal segments.

In order to express the gene of LEN-5 β-lactamase from a Klebsiella pneumoniae strain,plasmids in the strain were extracted and an 879bp product of LEN-5 gene was obtained with PCR.After being digested with Nde I and Xho I,LEN-5 gene was cloned into pET-26b (+) vector.Then it was confirmed by digestion and DNA sequencing in recombinant plasmid before transformed into E.coli BL21 (DE3).After inducing by IPTG,LEN-5 β-lactamase was expressed.Protein extraction was processed by ultrasonic and protein activity was detected by nitrocefin.The isoelectric focusing electrophoresis showed a pI of 7.6.These results indicated that the LEN-5 gene has been cloned and expressed in prokaryote cell successfully.

18F-fluorodeoxyglucose (FDG) PET/CT allows the functional information of PET to be fused with the accurate anatomical intormation from CT,it demonstrates unique advantages in lung cancer diagnosis,clinical staging,therapeutic evaluation and prognostic stratification.The metabolic parameters from 18F-FDG PET/CT include standardized uptake value,metabolic tumor volume,total lesion glycolysis and so on.This review summarizes the progress,problems and trends about 18F-FDG PET/CT parameters which are currently used in lung cancer.

Objective:To review the dual-time-point 18F-fluorodeoxyglucose (FDG) positron emission tomography/X-ray computed tomography (PET-CT) imaging for a patient with primary ureteric lymphoma (PUL),and explore the potential ofFDG PET-CT on diagnosis,staging and evaluation of treatment in patients with PUL.Methods:Complete clinical and imaging data of one patient with PUL was reported.The relevant literatures from 1997 to 2016 were reviewed,and the imaging features of uriteric lymphoma were analyzed.Results:The patient presented with microhematuria,a soft-density mass with moderate enhancement in the mid left ureter,and a luminal stenosis with the scope inserted 5 cm into the left stoma,but no mass was found.The patient was pathologically diagnosed as follicular lymphoma (stage IE confirmed by whole body FDG PET-CT).Conclusion:PET-CT may be useful in diagnosis,clinical stage and therapy assessment in patients with PUL.

BACKGROUNDTo evaluate the response, adverse effects and survival of MVP regimen and TVP regimen.

METHODSSixty six patients with advanced non-small cell lung cancer were randomized into two groups:MVP arm (32 patients, mitomycin C 6-8 mg/m² d1, vindesine 2-3 mg/m² d1 and d8, cisplatin 70-80 mg/m² d1) and TVP arm (34 patients, pirarubicin 40-50 mg/m² d1, vindesine and cisplatin were the same as arm MVP). Characteristics of the patients were similar in two arms. All patients received two to four cycles of chemotherapy.

RESULTSThe overall responses were 34% (11/32) in the MVP arm and 56% (19/34) in the TVP arm. There were 1 complete response, 10 partial responses in the MVP arm and 1 complete response, 18 partial responses in the TVP arm. TVP regimen appeared to have a higher objective response, but no statistically significant difference in the response was observed between two regimens (Chi-square=2.269, P=0.132). Main side effects were hematological toxicities. Grade III+IV hematological toxicities were significantly higher in the patients of arm TVP than arm MVP, especially neutropenia (79% vs 44%, Chi-square=7.458, P=0.006). Median survival time was 12 months vs 8 months, and 1-, 2-, 3-year survival rates were 53% vs 24% (Chi-square=4.943, P=0.026), 17% vs 6%, 6% vs 0, for arm TVP and arm MVP, respectively..

CONCLUSIONSMVP regimen has a lower response rate and longer survival time but less hematological toxicities than TVP regimen. The results suggest MVP regimen is a safe and active regimen for advanced non-small cell lung cancer.