Adolescent ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Cord ; pathology ; Spinal Cord Injuries ; diagnosis ; diagnostic imaging ; etiology ; pathology ; Spine ; diagnostic imaging ; Tomography, X-Ray Computed

Objective:To investigate the expression of CXCR4/CXCL12 and effect on the expression of CXCR4 by hypoxia in trophoblasts of human first trimester gestation.Methods:To detect the expression of CXCR4 and CXCL12 in placental tissue and primary cytotrophoblasts by immunohistochemistry and to assess the level of CXCR4mRNA under the condition of hypoxia in the trophoblasts of first trimester gestation by reas-time PCR.Results:The expression of CXCR4/CXCL12 were detected in the villous column,blood vessels and trophoblasts in the early pregnancy;CXCR4 mRNA was significantly higher through 12,24,48 and 72 h incubation periods in the hypoxic condition than that under normal oxygen condition respectively.Conclusion:Human first trimester trophoblasts produced CXCR4/CXCL12,which may play important biological role on the normal human pregnancy;Hypoxia could regulate the expression of CXCR4,which may contribute to the physiological pregnancy process.

Objective To investigate the expression of netrin-1 in placenta from patients with pre- eclampsia and the relation to placental angiogenesis.Methods Twenty patients with pre-eclampsia(12 mild cases and 8 severe cases)and 20 normal late pregnant women were investigated.The expression of netrin-1 mRNA and protein was determined with RT-PCR and Western blotting respectively.The placenta vascular density was examined by immunohistochemical F8 staining.Results (1)The values of netrin-1 mRNA in normal group and pre-eclampsia groups were 0.51?0.08 and 0.41?0.06;The values of netrin- 1 protein in normal group and pre-eclampsia groups were 26.4?1.8 and 20.5?1.3(P

In this study, we investigated the expression of CXCL12 (SDF-1)/CXCR4 in trophoblasts and the role they play in the gestation. Immunochemistry was used to detect the expression of CXCR4 and CXCL12 in human villi and placenta. Highly purified extra-villous trophoblasts (EVTs) ere detected for CXCR4 and CXCL12 in vitro by immunocytochemistry. The chemotaxis of CXCL12 was tested in transwell and the chemotactic activity was quantitatively examined. It was suggested that both CXCR4 and CXCL12 were expressed in trophoblasts and were decreased with the gestation time P < 0.05). In a certain coverage, CXCL12 exhibited chemotactic activity which was positively correlated with its concentration [(r) = 0.68, P < 0.01], the maximum chemotactic index (CI) was 1.62 +/- 0.12. Our results suggest that interaction between CXCR4 and CXCL12 is involved in materno-fetal immunological tolerance in all three trimesters of gestation and contributes to the invasion of EVTs during pregnancy.

Objective To investigate the relationship between neurokinin B (NKB), endothelin-1 (ET-1) and the pathogenesis of hypertensive disorder complicating pregnancy (HDCP). Methods 22 HDCP, who received antenatal examination in the Department of Obstetrics and Gynecology of Union Hospital of Tongji Medical College in Huazhong University of Science and Technology from March to July in 2005, were selected for the study, including 12 gestational hypertension (gestational hypertension group) and 10 preeclampsia (preeclamptic group); 22 normal pregnant women in the same period were served as control. At different gestational weeks, maternal plasma levels of NKB and ET-1 in three groups were detected by enzyme-linked immunoassay technique, the expression and location of NKB in placenta were examined by immunohistochemical SP, and mRNA expressions of NKB and ET-1 in placenta were measured with RT-PCR method. Results (1) At 10 - 14, 20 - 24, and 30 - 34 gestational weeks, the plasma levels of NKB and ET-1 in preeclamptic group were ( 35. 6±5.2), ( 17. 9±4. 3), (39. 5±4. 3 ), (22. 7± 3.6), (47. 1±3. 3) and (27.5±3.5) μg/L, respectively; in the control group they were (22. 9±3. 3), (10.7±5.3), (30.2±3.4), (13.2±4.1), (34.6±4.3) and (16.6±4.8) μg/L, respectively. There was a significant difference between preeclamptic group and control group ( P < 0. 05), while there was no significant difference between gestational hypertension group and control group (P>0.05).(2) Immunohistochemical staining for NKB protein was observed in all groups and was located in the villous syncytintrophoblast and villous vascular endothelial cells as well as cytoplasm of stromal cells, mostly located in villous syncytiotrophoblast. The expressions of NKB in placenta of preeclamptic group (0.244±0.020) was significantly higher than that in control group (0. 160±0. 012), with a significant difference between the two groups (P<0.05 ). However, there was no significant difference between gestational hypertension group (0.162±0.019) and control group (P>0.05). (3) The transcription levels of the NKB mRNA (0. 97±0. 36) and ET-1 mRNA (0. 90±0. 36) in preeclamptic placentas were both significantly higher than those in control groups (0. 78±0. 54, 0. 65±0. 47, respectively ), with a significant difference between the two groups( P <0. 05 ). But there was no significant difference between gestational hypertension group (0. 80±0. 40, 0. 70±0. 32, respectively) and control group (P >0. 05). (4) There was an evident positive correlation between plasma NKB and ET-1 levels in preeclampsia ( r =0. 79, P < 0. 05 ). Conclusions The significantly increased maternal plasma levels of NKB and ET-1 of patients with preeclampsia occur at early pregnancy (10 -14 gestational weeks) before the onset of clinical symptoms. The change of maternal plasma levels of NKB and ET-1 is closely related to pathogenesis of HDCP.

This study investigated the role of netrin-1 in placental vascular development. In vitro rat aortic ring assay and in vivo Matrigel plug assay were conducted to exmaine the effect of netrin-1 on angiogenesis. Human placental microvascular endothelial cells (HPMECs) were isolated and cultured and their viability, migration and tubular formation were studied, in order to examine the effects of netrin-1. The results showed that netrin-1 potently stimulated neovascularization in a mouse Matrigel plug in vivo and the sprouting of endothelial cells in rat aortic rings in vitro. In addition, netrin-1 enhanced the viability, migration and tube formation of HPMECs. Our study suggested that netrin-1 could significantly promote the formation of blood vessels of human placenta and may be a potential target for developing new therapeutic strategies for placental vasculature-related diseases.

Objective To understand the fluorescence pattern of antinuclear antibody(ANA)and the distribution of target anti-gen and ANA′s impact on rheumatoid arthritis(RA)RA.Methods The data of rheumatoid factor(RF)and anti-cyclic citrullinated peptide antibodies(anti-CCP antibodies)and ANA of 860 RA patients during 2014-2015 were collected and divided into 2 groups according to the ANA levels.The differences of RF and anti-CCP antibodies level between 2 groups were analyzed.Analyzed the fluorescence pattern of RA merger ANA and the distribution of target antigen by statistical.Results Of the 860 RA patients,the positive rate of ANA was 37.6%,the major fluorescence pattern of RA merger ANA was speckled pattern,anti SSA positive rate was 21.7%.The RF and anti-CCP antibodies level had statistical difference between ANA positive group and ANA negative group (P <0.05).Conclusion RA merger ANA positive can show different fluorescence patterns and target antigen,the speckled pattern and anti-SSA positive are the main pattern.The severity of arthritis symptoms and the degree of bone destruction between ANA positive group and ANA negative group were difference.Anti-ANA positive has a certain promoting effect on the progression of RA disease.

Objective To analyze the Clavien-Dindo classification and risk factors of complications after pancreaticoduodenectomy and investigate the relationship between the major risk factors and Clavien-Dindo classification of complications.Methods The retrospective case-control study was adopted.The clinical data of 200 patients who underwent pancreaticoduodenectomy at the Third Affiliated Hospital of Inner Mongolia Medical University from January 2010 to June 2015 were collected.The patients underwent Whipple surgery or pylorospreserving pancreaticoduodenectomy according to the tumor location.Observation indicators included:(1)postoperative complications using Clavien-Dindo classification,(2) univariate and multivariate analyses:the basic conditions of patients,surgery-related factors,pancreas-related factors,(3) relationship between independent risk factors and Clavien-Dindo classification of complications after pancreaticoduodenectomy.The univariate analysis and count data were done using the chi-square test.The comparison between groups was done using independent samples nonparametric test (Kolmogorov-Smirnov Z) and multivariate analysis was done using the Logistic regression model.Results (1) Postoperative complication situations:of 200 patients,122 underwent Whipple surgery and 78 underwent pylorus-preserving pancreatico-duodenectomy,including 6 combined with vascular reconstruction and 1 with radiofrequency ablation of liver tumors.Ninety-eight patients had postoperative complications,including 41 patients with 2 or above kinds of complications.Pancreatic fistula was detected in 80patients,including 42 with grade A,28 with grade B and 10 with grade C,wound infection in 29 patients,delayed gastric emptying in 24 patients,postoperative intra-abdominal infection in 16 patients,postoperative intraabdominal hemorrhage in 10 patients including 8 receiving interventional treatment,postoperative biliary leakage in 7 patients and unintended reoperation in 2 patients.Three patients were dead during hospitalization.The incidence of complications in grade Ⅰ,Ⅱ,Ⅲ (Ⅲ a and Ⅲ b),Ⅳ and V of Clavien-Dindo classification was 28.00％(56/200),13.00％ (26/200),5.00％ (10/200),1.50％ (3/200) and 1.50％ (3/200).(2) The univariate and multivariate analyses:the results of univariate analysis showed that body mass index (BMI) and texture of the pancreas were risk factors affecting complications after pancreatico-duodenectomy (x2=6.483,Z =-3.189,P ＜0.05).The results of multivariate analysis showed that BMI ＞ 23.9 kg/m2 and soft pancreas were independent risk factors affecting complications after pancreaticoduodenectomy (OR =2.044,1.649,95 ％ confidence interval:1.212-3.447,1.194-2.275).(3) The relationship between independent risk factors and Clavien-Dindo classification of complications after pancreaticoduodenectomy was analyzed,there were statistically significant differences between BMI or texture of the pancreas and Clavien-Dindo classification of complications after pancreaticoduodenectomy (x2 =13.897,27.077,P ＜ 0.05).Conclusions Clavien-Dindo classification of complications after pancreaticoduodenectomy is in favor of comprehensive comparisons and quality assessments among different studies,the primary classification is grade Ⅰ and Ⅱ.And decreasing BMI and good management of pancreatic stump may affect Clavien-Dindo classification of complications after pancreaticoduodenectomy.

Objective To evaluate the predictive value of plasma levels of soluble vascular endothelial growth factor receptor 1(VEGFR-1,also known as sFlt-1) in second-trimester for preeclampsia.Methods One hundred and forty-six pregnant women with normal blood pressure previously were prospectively included in the study.Peripheral venous blood samples were obtained between 20 and 26 gestational weeks.Plasma levels of sFh-1 were measured by an enzyme-linked immunoassay.Results (1) Among 146 previously normotensive women,12 developed preeclampsia (preeclampsia group), 134 remained normal pregnant till the end (normal group).(2) The plasma levels of sFh-1 in preeclampsia group [(4135?699)ng/L] was significantly higher than that in normal group[(1490?1033)ng/L](P

Objective To explore the feasibility of inter-laboratory comparison and trueness evaluation among clinical laboratories, and assess the quality of participants′measurement, by measuring the activity of alanine aminotransferase ( ALT ) in patient serum samples.Methods Method comparison study was used.Five patients serum samples, whose target values were assigned by two international candidate reference laboratory with reference method of ALT without pyridoxal phosphate, were measured by 23 routine laboratories.The bias between measurement result of each participant and the mean of reference laboratories was calculated, and then compared to allowable bias 6%.Calculate the mean value and the relative bias.Results Compared with the mean of reference laboratories, the maximum absolute value of bias among the 23 routine laboratories was 31.27%.The rate range which bias was less than the allowable bias was 26.09%-73.91 %.The bias acceptability of 8 participants were more than or equal to 80%;15 participants were less than or equal to 60%; and 3 participants were 0%.Conclusions Using patient serum samples and values assigned by reference method is an effective way to carry out inter-laboratory comparison and trueness evaluation.It can reflect the quality of measurement more truly.