Objective To evaluate the clinical effect and safety of umbilical cord ligation in the fetocide of complicated monochorionic multiple gestations.Methods From January 2009 to December 2012,clinical data of 18 women with complicated monochorionic multiple gestations who experienced intrauterine percutaneous umbilical cord ligation in Peking University Third Hospital were collected.Among the patients,6 were selective intrauterine growth restriction (1 with type Ⅰ,4 with type Ⅱ,1 with type Ⅲ) ; 4 were acrania or hydropic twins; 4 were aeardiac twins,2 were complicated triplet gestation; 1 was twin-twin transfusion syndrome with right ventricular dysplasia and 1 was monochorionic diamniotic (MCDA) with caesarean section history.The procedure was performed under both endoscopic and sonographic guidance.The gestational age at the time of the procedure were 17-27 +6 weeks.The procedure and perinatal outcome were analyzed.Results (1) The procedure was performed successfully in all the 18 cases.The average duration of the procedure was 63 min (24-156 min).The blood loss was 7.6 ml (5-20 ml).The mean gestational age at the time of the procedure was 20 weeks (17-27 +6 weeks).The average birth weight of the neonates was 2441 g(1000-3400 g).(2) There were 20 fetuses survived.Two fetuses had cardiac anomalies and were terminated in the following 2-3 weeks.Intrauterus fetal demise occured in 3 twin reverse arterial perfusion syndrome (TRAP) cases 3-14 weeks after the procedure.1 case delivered as early preterm birth at 28 weeks and the neonate died of respiratory distress syndrome (RDS) and hypoxie-ischemicencephalopathy (HIE).Fourteen neonates were in healthy and normal development by 3-51 months' followup.(3) Fourteen cases delivered at more than 28 weeks (28-38 weeks,averagely 33 + 1 weeks).The gestational weeks were prolonged by 5-21 weeks (averagely 13 +4 weeks).Among them,3 case were early preterm birth (28-33 weeks) and 3 were late preterm birth (34-36 weeks).Conclusion Percutaneous umbilical cord ligation is a reliable technique for the fetocide of complicated monochrionic mutilple gestations,especially for monochronic monoamniotie pregnancies.

To compare the effects of laparoscopic total or subtotal hysterectomy and myomectomy on ovarian reserve by measuring the serum level of anti-Mullerian hormone (AMH).A total of 96 patients with uterine fibroids underwent total laparoscopic hysterectomy (TLH group,n =32),laparoscopic subtotal hysterectomy (LSH group,n =31) and laparoscopic myomectomy (LM group,n =33).Changes in ovarian reserve were examined by measuring the level of AMH pre-operation and at 1 and 4 months post-operation.No significant differences existed in AMH in LM group[(1.42 ±0.65),(1.31 ±0.53) & (1.33 ±0.61) μg/L,P ＞ 0.05].The levels of AMH in both groups were significantly lower than those at pre-operation [(1.17 ± 0.11),(1.01 ±0.10),(0.48±0.54) & (1.18±0.93),(0.45 ±0.39),(0.14±0.0) μg/L,P＜0.001].The mean percentage decrease in AMH was lower in TLH group than that in LSH group at 4-month follow-up [(-37.4 ± 37.6) ％ vs.(-27.0 ± 23.0) ％,P =0.017].The results showed that LM had no effect on ovarian reserve.Both LSH and TLH had adverse effects on ovarian reserve and TLH was more marked.

Adult ; Ethylene Dichlorides ; poisoning ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neurotoxicity Syndromes ; etiology ; pathology ; Young Adult

Objective To analyze the relationship between autoimmune thyroid disease(AITD) and the genetic, immune and environmental factors. Methods A total of 500 patients with AITD and 206 healthy persons were included in this study. After carefully collecting the patient history and medical records, the inquiry forms were fulfilled to know about the genetic, immune and environmental factors. Statistical analysis was conducted using the SPSS statistical system. Results It was shown that family history of AITD, smoking and psychological factors were significantly different between AITD group and control(P0.05). Meanwhile, the difference of infection, contact with chemical poison, intake of sea food, miscarriage and blood type were also not significant between the patients and controls. Conclusion It is suggested that the heredity plays an important role in the pathogenesis of AITD. Smoking and psychological factors also have evident influence.

Five population groups, including farmers living in Veining (a cold hilly southern county), farmers and labourers in Shijiazhuang (a northern district), coastal fishermen in Zhoushan and "Yi" nationality farmers in Veining (where the incidence of hypertension is very low in China) were selected randomly (467 male subjects, 40-59 years old) to explore nutritional parameters-BP relationships. The results showed; (1) Pulse rate, QI and BP were lowest in Veining "Han" and "Yi" nationality groups. (2) Values of blood and urine nutritional parameters were in close accord with the diet customs of the different population groups. (3) Urine Na, Ca, Ca/Mg, urea nitrogen and serum cholesterol, total protein, albumin, uric acid were higher, while urine K was lower in hypertensives. (4) Urine Na, Na/K, Ca/ Mg and serum albumin, total protein, cholesterol, triglyceride, uric acid levels correlated positively, while K inversely with BP on multivariate stepwise regression and/or discrimination analyses. These results suggested high Na (Ca)-intake might be hypertensive, while high K(Mg)-intake an-tihypertensive, the serum protein - BP relationship could not be ascribed as a secondary effect of hemoconcentration in hypertension; a high protein intake, regardless of nature, could be hypertensionogenic; hyperlipidemia seemed to be a risk factor of hypertension, not being the secondary consequence to high BP. In designing a strategic protocol for primary prevention of hypertension, the above should be given due consideration.

Eight populations including 4 Chinese districts and 4 nationalities 484 subjects (male, 40~59 years) were conducted for exploring amino acid (22 sorts)-BP relationship by multi-variate regression and discrimination analyses. Results showed:(1)The different amino acid levels found among "Ka-zak", "Han" and "Uygur" nationalities living in one of the same Xinjiang region might be a reflection of their diverse dietary patterns; while the difference seen between "Han" and "Yi" nationalities living in one of the same Quizhou area, taking similar diet, might be due to the inherited metabolic influence. (2) The levels of aspartic and (or) glutamic acids were the the highest in the Quizhou "Han" and "Yi" groups living in cold hilly area, while other amino acids were comparatively lower, in keeping with their BP, Quetelet's indices and serum urea levels to be the lowest, tentatively denoting that the tissue metabolic turnover rate might be also lower as well in these groups. (3) The serum levels of sulfur containing amino acids in those populations taking much animal foods, were all higher, therefor ethe lower incidences of cardio-cerebro-vascular diseases seen in fishmen can not be thus wholly ascribed to the high intake of fish meat rich in sulfur containing amino acids. (4) From BP regression equations, valine, cysteine, alanine, threonine were found to be the prohypertensives while glycine, leucine, methionine and phenylalanine,the antihypertensives.

Objective:To summarize the pregnancy outcome of monochorionic triamniotic (MCTA) triplet pregnancy and its relationship with multifetal pregnancy reduction.Methods:This study retrospectively recruited 23 women with MCTA pregnancy who delivered at Peking University Third Hospital from January 1, 2012, to January 1, 2020. All 23 cases received regular prenatal examination at our hospital from the first trimester, who were divided into two groups: selective fetal reduction group (randomly reduced one fetus, n=8) and expectant group ( n=15). Pregnancy outcome was described in all participants, differences in maternal age, gestational weeks and outcomes were compared between the two groups. The selective fetal reduction group was further divided into two subgroups: first-trimester vacuum aspiration group ( n=3) and second-trimester radiofrequency ablation group ( n=5), to evaluate the differences in pregnancy outcomes. Two independent samples- t test and Fisher's exact test were used as statistical methods. Results:(1) There was no significant difference in the gestational weeks at the end of the pregnancy [(31.7±4.1) vs (28.8±8.8) weeks], preterm delivery after 32 weeks (9/15 vs 4/8), at least two surviving children (12/15 vs 4/8) and at least one surviving child (13/15 vs 5/8) between the expectant group and the selective fetal reduction group (all P>0.05). One case with twin-twin transfusion syndrome in the expectant group underwent fetoscopic surgery at 19 weeks of gestation and delivered three live infants through cesarean section at 33 +2 weeks due to premature rupture of membranes. One case with twin reversed arterial perfusion sequence at 17 weeks of gestation refused fetal reduction and gave birth to a child at 33 weeks when one fetus's heart stopped beating and one was acardia. (2) The first-trimester vacuum aspiration group and the second-trimester radiofrequency ablation group showed no significant differences in the average gestational weeks at the end of the pregnancy [(28.5±7.6) vs (28.9±10.4) weeks, t=1.145, P>0.05], or the rate of at least one (2/3 vs 3/5, Fisher's exact test, P>0.05) or two surviving children (2/3 vs 2/5, Fisher's exact test, P>0.05). No postoperative infection or amniotic fluid leakage was reported in the subgroups. Conclusions:The pregnancy outcome of MCTA triplet with fetal reduction is not different with expectant group.

BACKGROUND: Partial soft palate, uvula and the otiose soft tissue of lateral pharyngeal wall are resected in traditional uvulopalatopharyngoplasty. Although the syndrome can be improved, the complications, such as velopharyngeal insufficiency, cicatricial contration of pharyngeal cavity, can occur in some patients, furthermore, the prostecdtive efficacy is below the mark.OBJECTIVE: To investigate efficacy of the dilatation of oropharyngeal and nasopharyngealisthmus in uvulopalatopharyngoplasty treating obstructive sleep apnea hypopnea syndrome.DESIGN: A case-control observation.SETTING: The Affiliated Municipal Hospital of Medical College, Qingdao University.PARTICIPANTS: The patients who were hospitalized for snoring, apnea, breathing obstruction and somnolence were selected from the Sleep Respiratory Disorder Diagnosis and Treatment Center in the Affiliated Municipal Hospital of Medical College of Qingdao University from July 2001 to February 2006. We ascertained that the obstruction located at pharynx oralis, no hypertrophy of lingual root, and made a definite diagnosis of OSAHS by polysomnogram. The apnea hypopnca index (AHI) was ≥ 5 times per hour. Among 216 patients, there were 159 males and 57 females aged older than 25 years.METHODS: The patients were treated by modified UPPP which maintained the normal anatomic form of pharyngeal cavity, reserved the uvula, performed oblique straight incision along palatoglossal arch to soft palate, and avoided the incision of inverse U type. Palatoplasty and pharyngoplasty could extend the oropharyngeal isthmus and nasopharyngeal isthmus thoroughly.MAIN OUTCOME MEASURES: ① The survey of effect in the near future: Defined the pain without pain-killer as pain lightly, or as pain heavily inversely. If the lateral wall of oropharynx could remain the designed morphous, it was a good henosis; it was a bad henosis inversely. ② The survey of effect in a long term: According to the statement of the patients themselves. Estimated whether the patients had postoperative complications, such as backstreaming in nasal cavity, pharyngeal foreign body sensation, etc. Assessed if the patients had sleep apnea according to the observation of the family member and the monitoring of PSG. And ascertained whether the pharyngeal cavity had approached to normal structure by the examination of oropharynx.RESULTS: All 216 patients were involved in the final analysis. ① Of the 216 subjects, there were 156 patients who needed pain-killer (72%), and 60 Patients need not (26%). The lateral pharyngeal wall of 136 subjects was smooth (63%), and the other 80 were splited partly (37%). There were no complications such as breath holding, backstreaming in the nasal cavity. ② The survey of longdated postoperative effect: The 216 patients were followed up for 6 mouths.There was no deglutitive bucking, open rhinolalia. A total number of 84 patients (39%) had pharyngeal foreign body sensation. The syndrome of sleep apnea disappeared in 169 patients, and the other 47 patients still had the syndrome,but improved than before. In 203 patients (94%), the postoperative morphous of oral cavity were content, and the other 13 patients (6%) were not content. ③ The statistical significance of the preoperative and postoperative result of PSG monitoring of the 216 patients with OSAHS existed and the difference was significant [AI: 35.45±16.42, 12.75±9.62; HI:19.39±9.86, 17.43±10.15; AHI: 54.29±18.13, 28.31 ±16.23; the average low saturation of blood oxygen: (83.58±7.96) %,(85.53±8.18) %; the average saturation of blood oxygen: (91.98±3.29) %, (93.01±3.02) %, P ＜ 0.05].CONCLUSION: The modified uvulopalatopharyngoplasty indicates that this approach not only extend the nasopharynx cavity, but also avoids the postoperative complications. The patients have markedly improved symptoms.

The antitussive activity assay for the root extraction of Disporum cantoniense was carried out with coughing mice induced by ammonia liquor. The results showed that the ethanol and water extractions of D. cantoniense possess strong antitussive activity, and the high dose of the former was better than positive control, and then the constituents of the ethanol extraction were separated and purified by various modern chromatographic techniques. Their structures were identified by physico-chemical properties and spectroscopic data. As a result, eight compounds were isolated and identified as stigmast-4-en-3-one(1), (22E, 24R)-ergosta-5, 7, 22-trien-3beta-ol(2), obtucarbamate A(3), obtucarbamate B(4), neotigogenin(5), azo-2, 2'-bis[Z-(2,3-dihydroxy-4-methyl-5-methoxy) phenyl ethylene] (6),dimethyl {[carbonylbis (azanediyl)] bis( 2-methyl-5, 1-phenylene) j dicarbamate (7) , and quercetin-3-O-pB-D-glucopyranoside(8). All compounds were isolated from this plant for the first time, and the result of bioactivity-directed isolation showed that compounds 3, 4, and 6 had obvious effect on antitussive activity, and compound 6 had the same level as positive control.
Animals ; Antitussive Agents ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Ethanol ; chemistry ; Female ; Liliaceae ; chemistry ; Male ; Mice

Objective To analyze the factors affecting the efficacy of postoperative radiotherapy (PORT) in node-positive non-small cell lung cancer (NSCLC). Methods 480 patients with stage N_1-N_2 NSCLC after radical surgery were retrospectively reviewed. Of them, 267 patients received adjuvant chemotherapy and 121 received PORT. All patients were grouped based on the N stage, tumor size and lymph node positive ratio (the percentage of positive lymph nodes from the detected lymph nodes, LNPR). Group 1 included patients with tumor size ≤3 cm and LNPR ≤33%, group 2 was tumor size > 3 cm or LNPR > 33%, and group 3 was tumor size > 3 cm and LNPR > 33%. The endpoints were the local recurrence free survival (LRFS) and overall survival (OS). Kaplan-Meier method and Cox's proportional hazards regression model were used for the statistic analyses. Results PORT improved the overall survival only in patients with N_2 disease. Both tumor size and LNPR significantly influenced the efficacy of PORT. The 5-year LRFS for patients with vs. without PORT in the group 1, 2 and 3 were 55% vs. 60% (χ~2 = 0.03,P-0.869), 42% vs. 50% (χ~2 =0.31,P=0.547),and 62% vs. 52% (χ~2=4.25,P=0.036), respectively;and the corresponding OS were 22% vs. 50% (χ~2 = 1.65 ,P =0. 199), 26% vs. 22% (χ~2= 0. 13,P=0.786) and 42% vs. 16% (χ~2= 15.33,P=0.000), respectively. Conclusions Tumor size and LNPR significantly impact the efficacy of PORT . For patients with stage N_2 NSCLC , PORT could improve local recurrence free survival and overall survival when tumor size > 3 cm and LNPR >33%.