Objective To investigate the variation of cytokines IL-4, IL-1? and TNF-? before and after the onset of pregnancy induced hypertension (PIH) and to discuss the role of cytokine in the pathogenesis of PIH. Method A prospective cohort study of 550 pregnant women were followed. Plasma drawn from 25 women who developed moderate and severe PIH and 30 controls at 12~16 and 32~36 gestational weeks were analyzed. The concentrations of IL-4, IL-1? and TNF-? were analyzed using ELISA method. Results (1)In the second trimester, the plasma level of TNF-? in PIH group was significantly higher than control group(27.66 ng/L vs 17.80 ng/L, P

Objective To explore the interactive effect of acupuncture and exercise on severe traumatic brain injury (TBI). Methods 120 comatose patients following TBI after routine surgery were equally divided into combined group (acupuncture and exercise), acupuncture group, exercise group, and control group (neither acupuncture, nor exercise). They were assessed with Glasgow coma scale (GCS),Fugl-Meyer assessment (FMA), modified Brathel index (MBI) and neurological deficit scores (modified Edinburgh-Scandinavia stroke scale, MESSS) before and after the treatment. Results The scores of GCS, FMA, MESSS and MBI improved more in the combined group than in the control group (P<0.05). The scores of GCS and MESSS improved more in the acupuncture group and the exercise group than in the control group (P<0.05). The scores of MESSS improved more in the combined group than in the exercise group (P<0.01). Conclusion Both acupuncture and exercise can synergetically reduce the disability and coma of comatose patients following TBI.

Objective To investigate the expression of human papillomavirus (HPV) L1 protein in lesional tissue of condyloma acuminatum and its clinical significance.Methods Forty-three patients with condyloma acuminatum were included in this study,and received CO2 laser therapy.Tissue samples were resected from the lesions of these patients at their first visit before treatment.Immunohistochemistry was used to determine the expression of HPV L1 protein in these samples.Follow up was carried out once every 2 weeks for 3 months to assess the recurrence rate and frequency in these patients after treatment.Results HPV L1 protein was detected in 83.72％ (36/43) of these tissue samples.The expression rate of HPV L1 protein decreased sequentially from patients infected with HPV 6/11,patients with both HPV 6/11 and 16/18,to those with HPV16/18 (x2 =17.90,P ＜ 0.01).During the 12 weeks of follow up,the recurrence rate was 69.77％ (30/43) with the average number of recurrence of 2.16.There was a sequential reduction in the recurrence rate and number from patients with strong expression of HPV L1 protein,to those with moderate expression,slight expression and negative expression (x2 =8.02,46.92,P ＜ 0.05 and 0.01,respectively).The expression intensity of HPV L1 protein was negatively correlated with the recurrence rate and frequency (rs =-0.429,-0.696,respectively,both P ＜ 0.01).Conclusion HPV L1 protein may serve as a helpful molecular biomarker for the prediction of prognosis and recurrence of condyloma acuminatum.

Objective To evaluate the diagnostic value of galactomannan(GM) detection for invasive aspergillosis infections in pediatric patients, a Meta-analysis was performed.Methods According to selection criteria, studies indexed by PubMed,EMBASE,Medline,CNKI and Wanfang Data on GM testing in pediatric aspergillosis were included from January 2001 to November 2012. The methodological quality was assessed by QUADAS, sources of heterogeneity investigated, pooled effect quantities evaluated, and summary receiver operative curves(ROC) and subgroup analysis performed.Stata12.0 was used to analyze diagnostic parameters, such as, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve(AUC). Results Thirteen articles with 16 sets of data were included.The weighted sensitivity and specificity with 95% confidence interval were 0.71(0.60-0.79)and 0.94(0.89-0.96), respectively.Under different cut-off values, sensitivities of GM assay in diagnosis of pediatric aspergillosis were 0.71(0.54-0.84) for 0.5, 0.77(0.64-0.87) for 0.8, 0.72(0.58-0.84) for 1.0 and 0.59(0.39-0.76) for 1.5, and its responding specificities were 0.94(0.89-0.97), 0.89(0.82-0.93), 0.89(0.81-0.94) and 0.91(0.88-0.94).Conclusion Under the cut-off value of 0.8, the GM assay is a useful method in the detection of pediatric invasive aspergillosis.

Objective To investigate the relationship between CT characteristics and histological differentiation of soft tissue sar-comas.Methods Forty-two cases with pathologically proved soft tissue sarcomas were collected.The tumor size,morphology,den-sity and relationship of the tumor to the adjacent structures on CT were analyzed retrospectively.The value of the CT signs in evalu-ating the histological differentiation of the tumor was explored.Results The maximal diameter of the tumor was over 5 cm in 36 ca-ses.Oval shape was seen in 29 cases and irregular shape was seen in 13 cases.Heterogeneous density was seen in 32 cases including intratumoral calcification in 3 cases and intratumoral necrosis in 22 cases.Adjacent structures were infiltrated in 25 cases.Compared to the pathological results,intratumoral necrosis and invasion of adjacent structures were related to the degree of histological differ-entiation (P <0.05),and the relation coefficients were 0.64 and 0.57,respectively (P <0.01).Conclusion Intratumoral necrosis and invasion of adjacent structures are correlated with the histological differentiation of the soft tissue sarcomas.They may reflect the biological behavior of low-differentiated or undifferentiated soft tissue sarcomas to some extent.

Objective To make a systematical review of the efficacy and safety of endoscopic variceal ligation versus endoscopic variceal sclerotherapy for treatment of esophageal variceal bleeding. Methods We electronically searched databases including PubMed, Web of Science, The Cochrane Library (Issue 2, 2016), CNKI, WanFang Data and from Jan., 1980, to Mar., 2015, collected randomized controlled trials (RCTs) about EVL versus EVS for the patients of esophageal variceal bleeding. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 24 studies including 2020 patients were included. The results of meta-analysis showed that, there were no signiifcant differences in the variceal eradication rate (RR=1.04, 95%CI 0.99 to 1.09, P=0.090) between the EVL group and the EVS group; Compared with the EVS group, the EVL group could significantly reduce the rate of variceal rebleeding (RR=0.69, 95%CI 0.59 to 0.81, P=0.000), the rate of mortality (RR=0.76, 95%CI 0.63 to 0.90, P=0.002) and the rate of complication (RR=0.41, 95%CI 0.26 to 0.63, P=0.000), but the rate of variceal recurrent rate of EVS group was lower than that of the EVL group (RR=1.67, 95%CI 1.40 to 2.01,P=0.000). Conclusion Current evidence shows that, the variceal eradication rate between EVL and EVS is similar, but the EVL has less incidence of variceal rebleeding and mortality and complication.

Objective To compare the prognosis and life quality of patients with early-stage breast cancer(stage I or II)undergoing breast-conserving surgery or modified radical mastectomy.Methods 180 cases with early-stage breast cancer were divided into 2 groups:breast-conserving surgery group(BCS)and modified radical mastcctomy group(MRM),with 90 cases in each group.The 2 groups were all given radiotherapy,chemotherapy and endocrine therapy according to indications.The prognosis and life quality in the 2 groups were compared.Results The 5-year-postoperative follow-up showed there was no significant difference in duration of disease-free survival(DFS)of the 2 groups.However,life quality of BCS patients was significantly better than that of MRM patients in terms of general health,physical function,pain,vitality,social functioning,emotion and mental health.Conclusion Breast-conserving surgery is highly recommended for patients with early-stage breast cancer.

Objective To explore the management of perioperative period on the effect of alimentary tract fistulas after gastric cancer operation.Methods The clinical data of 25 patients with alimentary tract fistulas after gastric cancer operation were reviewed.The location and time of alimentary tract fistulas,and perioperative period of patients were analyzed.Results Of the 25 patients,13 cases(52.0％) were anastomotic fistulas,1 case(4.0％) was bile fistula,2 cases (8.0％) were pancreatic fistulas,4 cases (16.0％) were small intestinal fistulas,and 3 case (12.0％) were duodenal stump fistulas,1 case (4.0％) was anastomotic and duodenal stump fistula,1 case (4.0％) was small intestinal and duodenal stump fistula.The alimentary tract fistulas generally occurred within the first or second week after gastric cancer operation.The incidence rate of gastrointestinal leakage was 64.0％ in gastric cancer with diabetes patients,56.0％ in gastric cancer with elderly patients,40.0％ in gastric cancer with anemia patients,36.0％ in gastric cancer with hypoproteinemia patients,16.0％ in gastric cancer with multivisceral excisions.21 cases of gastrointestinal leakage were healed after conservative treatment.2 cases with gastrointestinal leakage by operation treatment were healed.2 patients died,one died of intra-abdominal hemorrhage,one case died of MODF.Conclusion Strengthening the management of patients with alimentary tract fistulas after gastric cancer operation can promote the healing of fistula in perioperative period.

Objective To study the prevalence and associated factors of secondary hyperparathyroidism (SHPT) in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods A cross-section study was performed.A total of 639 eligible participants undergoing CAPD treatment more than three months in our peritoneal dialysis center from July 2011 to January 2012 were recruited in the study.All the patients were divided into SHPT group and non-SHPT group according to the intact parathyroid hormone (iPTH) level,and the associated factors of SHPT were investigated through Logistic regression analysis.Results The prevalence of SHPT was 46.95％ (300/639).Logistic regression analysis demonstrated that lower hemoglobin,hypocalcemia,hyperphosphatemia,higher alkaline phosphatase,higher Scr,higher nPCR and low calcium dialysate were independent influencing factors of SHPT.Conclusions The prevalence of SHPT is quite high in CAPD patients.Abnormal calcium-phosphorus metabolism,renal anemia,high protein diet and low calium dialysate may affect the SHPT.

Objective To evaluate right ventricular(RV)function by tissue Doppler imaging(TDI)and Tei index in patmnts with coronary artery disease(CAD).Methods One hundred twenty patients who underwent coronary angiography(CAG)were enrolled.Based on clinic evidences,such as CAG,disease history,symptom,ECG,and myocardial enzymes,all patients were divided into three groups:control group,angina group and myocardial infarction(MI)group.TDl was performed on the lateral and septal tricuspid annular.RV Tei index was obtained either from the pulse-wave Doppler(PW-Tel)and from TDI(TDI-Tei).Results There were significant differences in RV PW-Tei,TDI-Tei,Ea,and Ea/Aa among three groups.PW-Tei was 0.363±0.086.0.463±0.078 and 0.569±0.066,and TDI-Tei was 0.400±0.058,0.520±0.078 and 0.628±0.059 for the control group,angina group and MI group,respectively.Ea and Ea/Aa were gradually decreased following the severity of CAD.Sa was no difference between the control group and angina group,while Sa was much lower in mvocardial infarction group than in other groups.RV PW-Tei had a good correlation with the lateral and septal TDI-Tei.The lateral and septal TDI-Tel were significant correlated with motion velocities.Conclusions TDI can be used to comprehensively evaluate RV function in patients with CAD.TDI-Tei can sensitive reflect the damage level of overall RV function in patients with different degree CAD.