Purpose:To study the expression of uPA in gestational trophoblastic cells and the relationship between uPA and the invasiveness of malignant trophoblastic tumor. Methods:73 samples from patients with gestational trophoblastic disease were harvested.In situ hybridization was employed to detect uPA expression in all of these samples. Results:① There was significant difference in the expression of uPA in cytotrophblasts among hydatidiform mole,invasive mole and choriocarcinoma(P

Objective To observe the clinical efficacy and anticoagulant effects and safety of low-molecular-weight heparin (LMWH) on treatment of refractory nephrotic syndrome(NS).Methods 33 patients of primary NS complicated with hypercoagulability were randomly divided into two groups: the control and the treatment groups. The control group was treated with prednisolone(1mg/kg/d) plus oral cyclophosphamide (50mg bid) and methylprednisolone 0 5～1g(20mg/kg/time) in glucose 250ml(5%) intravenously by drip . While the treated group was administered, on the basis of the therapeutic scheme of the control group, with subcutaneous injection of LMWH (5000IU bid) for 4 weeks, the clinical symptom was observed in both groups before and after the treatment ,the 24h urine protein quantitative determination,renal function,anti thrombin III (AT-III) activity,fibrinogen(FIB),D-dimer(DD),plasma factor Xa( Fxa),plasma factor IIa(FIIa) were also tested, the side effects in two groups were observed at the same time. Results The 24h urine protein quantitative determination,blood urea nitrogen(BUN) and serum Cr were significantly decreased(P

Objective To observe the effect of Guxi Recipe 2 combined with joint loosening training for the treatment of postoperative ankylosis in tibial plateau fracture patients.Methods Thirty-two patients with postoperative ankylosis had active exercise combined with small-range continuous passive motion(CPM) 2 weeks after operation,and received steaming and washing with Guxi Recipe 2(mainly composed of Herba Menthae,Radix Saposhnikoviae,fermented soybean,Rhizoma et Radix Notopterygii,Ramulus Cinnamomi,Radix Clematidis,Radix Pterospermi Heterophylli,Radix Angelicae Pubescentis,Olibanum,Cortex Acanthopanacis,and Myrrha) combined with CPM and manipulation for loosening joint 3 weeks after operation.The function of knee joint was assayed with the criteria of knee joint function evaluation issued by the Hospital for Special Surgery(HSS) 6 and 12 months after operation.Results The results of knee joint function scoring showed that the therapeutic effect was excellent in 21 patients,good in 8,average in 3,and the excellent and good rate was 90.6%.Conclusion Guxi Recipe 2 combined with joint loosening training is effective on the recovery of knee joint function of tibial plateau fracture patients with postoperative ankylosis.

This study aimed to induce the differentiation of isolated and purified adipose-derived stromal cells (ADSCs) into myoblasts, which may provide a new strategy for tissue engineering in patients with stress urinary incontinence (SUI). ADSCs, isolated and cultured ex vivo, were identified by flow cytometry and induced to differentiate into myoblasts in the presence of an induction solution consisting of DMEM supplemented with 5-azacytidine (5-aza), 5% FBS, and 5% horse serum. Cellular morphology was observed under an inverted microscope. Ultrastructural changes occurring during the differentiation were observed by transmission electron microscopy and confocal laser scanning microscopy. Cellular immunohistochemical staining was applied to determine the expression of desmin protein in cells with and without induced differentiation. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to detect mRNA and protein expression, respectively, of sarcomeric and desmin smooth muscle proteins. The results showed that ADSCs were mainly of a spindle or polygon shape. Flow cytometry analysis revealed that ADSCs did not express CD34, CD45, and CD106 but high levels of CD44 and CD90, which confirmed that the cultured cells were indeed ADSCs. After induction with a 5-aza-containing solution, morphological changes in ADSCs, including irregular cell size, were observed. Cells gradually changed from long spindles to polygons and star-shaped cells with microvilli on the cell surface. Many organelles were observed and the cytoplasm was found to contain many mitochondria, rough endoplasmic reticulum (rER), and myofilament-like structures. Cell immunohistochemical staining revealed different levels of desmin expression in each phase of the induction process, with the highest expression level found on day 28 of induction. RT-PCR and Western blot results confirmed significantly higher desmin gene expression in induced cells compared with control cells, but no significant difference between the two groups of cells in sarcomeric protein expression. It was concluded that under specific induction setting, ADSCs can be induced to differentiate into myoblasts, providing a potential new option in stem cell transplantation therapy for SUI.

Objective To study the feasibility, safety, tolerance and the effectiveness of constraint-induced movement therapy (CIMT) in early cerebral infarction, and the long-term outcome.Methods 2 weeks after cerebral infarction, 22 patients with upper extremity weakness were divided into treatment group (11 cases, accepted CIMT) and control group (11 cases, accepted routine rehabilitation). They were assessed with Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL) and Barthel Index (BI) before and 2 weeks, 3 months after treatment. Results The scores of FMA, WMFT, MAL and BI improved in both group (P<0.05), but more in the treatment group (P<0.05). 3 months after treatment, the score of MAL quality was no different between two group.Conclusion CIMT is safe and effective for early cerebral infarction, and more effective than routine immediately, but it is similar 3 months later.

Objective To investigate the pathologic morphology and immunohistochemical phenotypes of sarcomatoid carcinoma(SC) of the fallopian tube.Methods One case of SC of the fallopian tube was studied under the light microscopy for morphology.Immunohistochemistry was used to detect the expression of CK,EMA,S-100,Desmin,SMA,Leu-7,CD68,actin,and Vimentin in SC tissues.Pathologic features and biological behaviors of SC were analyzed in combination with the review of literature.Results Microscopically carcinomatous and sarcomatous elements co-existed.Usually the sarcomatous element formed the bulk of the lesion.In the sarcomatous tissues,there was no distinguishable bone,cartilage,rhadomyosarcoma,etc. Immunohistochemically the strong expression of CK7,EMA and Vimentin,and the partial expression of S-100,SMA,Leu7,CD68 and actin were detected.Conclusion SC of the fallopian tube is lack of specific symptoms,and its preoperative diagnosis is difficult.B-ultrasonography,CT and MRI are helpful to the staging of SC.Final diagnosis of SC depends on pathological examination and immunohistochemistry.SC is rare,and undergoes blood metastasis in early stage.Prognosis of SC is worst.Early detection of SC is the key to improve the prognosis.

Objective To evaluate the outcome of unconstrained shoulder arthroplasty in treatment of se- vere damages of shoulder and proximal humerus.Methods Eleven cases of unconstrained shoulder arthroplasty were carried out in our department from 1999 to 2004.The average age of the 11 patients was 65 years.Nine cases underwent hemi-arthroplasty for their complex fractures of proximal humerus with unstrained protheses and two cases received total shoulder arthroplasty for their shoulder osteoarthritis.Cemented prostheses were used in all the cases. Results Follow-ups averaged 2.3 years.Two cases of four-part fractures reported slight pain and limited external rotation of the shoulder after operation,while there was no pain or loosening of prosthesis in all the other cases who recovered full range of motion.Conclusion Unconstrained shoulder arthroplasty is a satisfactory and safe tech- nique for severe damages of proximal humerus.

This study aimed to induce the differentiation of isolated and purified adipose-derived stro-mal cells (ADSCs) into myoblasts, which may provide a new strategy for tissue engineering in patients with stress urinary incontinence (SUI). ADSCs, isolated and cultured ex vivo, were identified by flow cytometry and induced to differentiate into myoblasts in the presence of an induction solution consisting of DMEM supplemented with 5-azacytidine (5-aza), 5% FBS, and 5% horse serum. Cellular morphol-ogy was observed under an inverted microscope. Ultrastructural changes occurring during the differen-tiation were observed by transmission electron microscopy and confocal laser scanning microscopy. Cellular immunohistochemical staining was applied to determine the expression ofdesmin protein in cells with and without induced differentiation. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to detect mRNA and protein expression, respectively, of sarcomeric and desmin smooth muscle proteins. The results showed that ADSCs were mainly of a spindle or polygon shape. Flow cytometry analysis revealed that ADSCs did not express CD34, CD45, and CD106 but high levels of CD44 and CD90, which confirmed that the cultured cells were indeed ADSCs. After induction with a 5-aza-containing solution, morphological changes in ADSCs, including irregular cell size, were observed. Cells gradually changed from long spindles to polygons and star-shaped cells with microvilli on the cell surface. Many organeUes were observed and the cytoplasm was found to contain many mito-chondria, rough endoplasmic reticulum (rER), and myofilament-like structures. Cell immunohisto-chemical staining revealed different levels ofdesmin expression in each phase of the induction process, with the highest expression level found on day 28 of induction. RT-PCR and Western blot results con-firmed significantly higher desmin gene expression in induced cells compared with control cells, but no significant difference between the two groups of cells in sarcomeric protein expression. It was concluded that under specific induction setting, ADSCs can be induced to differentiate into myoblasts, providing a potential new option in stem cell transplantation therapy for SUI.

From March 2019 to May 2019, panel interviews were conducted with 39 representatives of 10 community health service centers in Shanghai Changning District, each took 30 to 90 min. The relevant information of interviews was coded, classified, streamlined, and the interview topics were sorted out. The interviews showed the following problems of continuing education in community health care setting currently: there were lack of updated disease-related clinical guidelines and other knowledge, lack of uniform regulations on rational drug use; the contents or forms of training did not match the needs of the community; and training in psychology and nutrition therapy could not be transformed into practical application. The participants made the following suggestions for continuing medical education: to build a database of clinical guidelines for diseases; to provide information-based support and guidance for rational drug use; to design training contents and training forms based on community needs; to provide training support in psychology, nutrition and other subjects; to increase trainings in research, teaching and health management and other aspects. Continuing medical education for community general practioners faces problems from knowledge users, knowledge providers, and the policy environment. The contents and forms of training needs should be optimized. These can be strengthened by communicating with the community and following up with the needs of the community in establishing diversified training forms, supporting assessment and incentive mechanisms for different types of training contents.