Objective To investigate the significance of thyroid function screening in high-risk pregnant women with gestational diabetes (GDM) in early pregnancy.Methods A total of 194 cases with GDM were selected as our subjects.The patients were divided into group A(three normal items,a total of 109 cases),group B (one abnormal item,a total of 57 cases) and group C (two abnormal items,a total of 28 cases).The levels of serum anti-thyroglobulin antibody (TGAb),anti-thyroid peroxidase antibody (TPOAb),serum three triiodothyronine(TT3),thyroxine (TT4),free three triiodothyronine (FT3),free thyroxine (FT4) and thyroidstimulating hormone (TSH) were screened.Results TSH levels in group A was (1.45 ± 0.43) mU/L,significantly lower than in group B and group C((1.77±0.53),(1.89±0.74) mU/L).FT4 levels in group A was (11.62±0.98) nmol/L,significantly higher in group B and group C((10.23±0.75),(9.87±0.88) nmol/L)).Proportion of TPOAb,TGAb positive in group A were 9.17％(10/109) and 21.05％(12/57),significantly lower than that of group B and group C((28.57％(8/28) and 3.67％(4/109),7.02％(5/57) and 17.86％(5/28)).And the differences were significant (P＜ 0.05).And TPOAb + TGAb in group A was 0.92％(1/109),significantly lower than that of group B and group C(7.02％ (4/57),17.86％ (5/28);P ＜0.05).Conclusion The importance of screening thyroid function in early pregnancy in women at high risk for gestational diabetes is worthy of clinical promotion.

Objective To analyze the tendency of hospital based surveillance incidence rates of birth defects in Guangdong province to provide reference evidence for related intervention program. Methods Data from hospital based birth defects surveillance of Guangdong province during 1997-2007 were analyzed retrospectively. Results The overall surveillance rates of birth defects in Guangdong province showed an increasing trend form 98.9 per 10 000 birth in 1997 to 244.2 per 10 000 birth in 2007. Among the frequently seen birth defects, the rate of congenital heart diseases increased sharply, but the rates of congenital talipes equinovarus, polydactyly, cleft lip with/without cleft palate showed a slight increasing trend.It seemed that there was a significant difference between different maternal age interval and gender of the infants. Mother's illness, drug use, and exposure to environment harmful factors in early pregnancy stage, high maternal age, negative bearing history were the suspect risk factors for birth defects. Conclusion The increasing trend of surveillance rate of birth defects seemed to be comprehensively affected by the factors as: method being adopted, target and extension of birth defects surveillance, technology used for diagnosis, kinds of risk factor,and quality control on surveillance programs.

Objective To investigate the efficacy and safety of Bushen Huoxue Decoction in the treatment of carotid atherosclerotic plaque. Methods Totally 50 patients of carotid atherosclerotic plaque were collected to conduct health education. At the same time, they were given Bushen Huoxue Decoction, one dosage a day, twice a day, decoction, for 12 weeks. The correlation indexes of carotid artery before and after treatment were observed, and TCM syndrome integrals were evaluated before and after 4, 8 and 12 weeks treatment. FBG, TC, LDL-C, CRP HCY, IL-6, IGF-1, and OPG were detected before and after treatment. Hematuria routine, liver and renal function were monitored. Results After treatment, the Crouse score and the plaque grade score of carotid atherosclerotic plaque showed a tendency to decrease, without statistical significance (P=0.060, P=0.336). Carotid maximal plaque area and modified total score of carotid atherosclerotic plaque were significantly reduced compared with that before treatment (P<0.05). TCM syndrome integrals were significantly reduced compared with that before treatment (P<0.05), and the scores decreased significantly with the prolongation of treatment time. TCM syndrome integrals after 4, 8, and 12 weeks were significantly reduced compared with that before treatment (F=160.352, P<0.001). Total effective rate of treatment in the efficacy of TCM syndrome was 85.11％ (40/47). Serum levels of FBG and TC decreased significantly after the treatment compared with that before the treatment, with statistical significance (P<0.05). Serum levels of LDL-C, HCY, CRP, IL-6, IGF-1, and OPG all showed a tendency to decrease, without statistical significance (P>0.05). No abnormality in hematuria routine, liver and renal function examinations were found during the research. Conclusion Bushen Huoxue Decoction has obvious clinical efficacy for carotid atherosclerotic plaque, which can improve clinical symptoms of patients, it also could stabilize and reduce plaque with high safety.

Objective To investigate the effect of green light laser in complex posterior urethral stricture after surgical treatment of benign prostatic hyperplasia (BPH).Methods Green light laser was applied in treating 20 cases of complex iatrogenic posterior urethral stricture.Of these cases,12 had false passages,5 had more than 2 strictures and 5 had concurrently urethratresia.The scar tissues were transure- thrally vaporized and resected.The in-dwelling urethral catheter time was 1-2 months after operation. Results All the patients were initially cured without serious complications.The mean operative time was 39 rain (range,30-65 min).During the follow-up of 2-10 months,1 case had mild incontinence:another case (Q_(max)＜9ml/s 2 weeks after surgery) got satisfactory results(Q_(max)＞15ml/s)after the scheduled urethral dilatation.The other 18 cases were treated successfully and voided fluently with postoperative Q_(max)＞15ml/s in all.Conclusions It is suggested that transurethral green light laser procedure is not only safe and ef- fective,but also simple and minimally iuvasive for complex posterior urethral stricture following surgical treat- ment of BPH.

Objective To investigate the phenotype, frequency and function of CD4 + T cell subsets and the relevant cytokines, as well as the relationship between these cells and appearance of pneumonia of novel (H1N1 ) influenza A patients. Methods 68 healthy people,53 confirmed novel A( H1N1 ) influenza patients without pneumonia and 16 confirmed severe novel A( H1N1 ) influenza patients with pneumonia were enrolled in this study. Viral load in nasopharyngeal swabs specimens was measured by real time PCR assay.The phenotype and percentage of CD4+ T cell subsets including Th1, Th2, Th17, and Treg cells were measured by Flow cytometry analysis. The relevant cytokines in plasma including TGF-β, IL-6 and IFN-γ were measured by ELISA. Data was analyzed by one way ANOVA. Results It was found that peak viral load and viral shedding period of severe patients with pneumonia was significantly increased compared with mild patients without pneumonia ( P ＜ 0. 05 ). The percentage of Th17 cells of severe patients with pneumonia was significantly diminished compared to that of healthy subjects and mild patients without pneumonia( P ＜ 0. 05 ). However, Th1 ,Th2, Treg cells frequencies had no significant differences ( P ＞ 0. 05 )among these three groups. The level of TGF-β in plasma for the severe patients with pneumonia was also significantly decreased compared to that of healthy subject and mild patients without pneumonia( P ＜0. 05 ).The viral shedding period inversely correlated with the frequency of Th17 cells ( r = - 0. 38, P ＜ 0.05 ).Conclusion H1N1 influenza A virus can inhibit Th17 cells to differentiate, particularly more extent in patients with pneumonia. Impaired Th17 cells may correlate with viral clearance and pneumonia of novel H1N1 influenza A patients.

OBJECTIVETo investigate the feasibility, reliability and therapeutic effectiveness of adjuvant chemotherapy for advanced hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT).

METHODSThe clinical data of adjuvant chemotherapy after OLT in 10 advanced HCC patients were studied retrospectively. FAP chemotherapy regimen was adopted calcium folinate (CF) 200 mg/m(2) and 5-Fluorouracil 500 mg/m(2) iv on D1 to D5, and doxorubicin 40 mg/m(2), cisplatin 30 mg/m(2) iv on D1, with 28 days as a cycle. The opportune time of chemotherapy, chemotherapy regimen, synergistic action between cytotoxic agent and immunosuppressive agent on liver and kidney and side-effects were preliminarily evaluated.

RESULTS7/10 patients are surviving, with the longest survival of 32 months, and the shortest 9 months. Three patients died after operation, two at 13 months, one at 20 months after OLT, all died of metastasis. The incidence of one year survival was 9/9. During the period of chemotherapy, the side-effects of adjuvant chemotherapy were moderate.

CONCLUSIONChemotherapy which is able to prolong the life-span of patients with advanced HCC after orthotopic liver transplantation is feasible and effective, the side-effects were mild. The choice of opportune time of chemotherapy might influence the outcome.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Doxorubicin ; administration & dosage ; Drug Administration Schedule ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Leucovorin ; administration & dosage ; Liver Neoplasms ; drug therapy ; pathology ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Period ; Retrospective Studies ; Survival Rate

The Cry1Ab differs most significantly from the other related ICPs by its absence of a carboxyl terminus of 28 amino acids including four cysteines; consequently it is less stable. We report that the helper protein P20 plays a role in the expression and crystallization of Cry1Ab. Three Cry1Ab expression plasmids pT1B, pP1B, and pDP1B, were constructed based on the shuttle vector pHT3101. The vector pT1B does not contain the p20 gene, pP1B carries p20, and pDP1B contains p20 with cry1A(c) promoter. Transformants were obtained by electroporating the plasmids into Bacillus thuringiensis acrystalliferous mutant CryB. Western blot demonstrated that crylAb was expressed as a 130 kD protein in all the transformants, and some of the protein was partially degraded into a 60 kD peptide. Quantitative protein analysis indicated that the amount of the 130 kD protein varied in the transformants and was in the ratio of 1:1.4:1.5 for PT1B, pP1B and pDP1B respectively. For the 60 kD proteins, the ratio was 1:1.1:1.6. Microscopic examination revealed that the size of the typical pyramidal crystals in the three transformants was in the order of T1B < P1B < DP1B. Bioassay showed that T1B, P1B and DP1B were all toxic to the larvae of Helicoverpa armigera with similar LC50. This study suggested that P20 plays a role in the expression and crystallization of Cry1Ab.
Animals ; Bacillus thuringiensis ; genetics ; metabolism ; ultrastructure ; Bacterial Proteins ; genetics ; metabolism ; pharmacology ; Biological Assay ; methods ; Blotting, Western ; Electroporation ; Endotoxins ; genetics ; metabolism ; pharmacology ; Hemolysin Proteins ; genetics ; metabolism ; pharmacology ; Microscopy, Electron, Transmission ; Moths ; drug effects ; Promoter Regions, Genetic ; genetics

Adolescent ; Adult ; Female ; Humans ; Kidney Pelvis ; surgery ; Laparoscopy ; methods ; Male ; Middle Aged ; Robotics ; Ureteral Obstruction ; surgery ; Urologic Surgical Procedures ; methods

Objective:To investigate the preliminary effects of sub-pectoral fascial breast augmentation and reconstruction.Methods:Six patients (10 breasts) of mammary dysplasia, mastatrophy, prophylactic mastectomy, unilateral breast defect with contralateral mastatrophy were included in the study from Oct. 2019 to July 2021. The mean patient age was 29 years (range, 20 to 35 years). All the textured and smooth cohesive gel implants were inserted under pectoralis major fascia by endoscopic-assisted, incisions were including axillary, around areola and inferior mammary fold approaches. The prophylactic mastectomy cases were performed nipple sparing mastectomy and sub-pectoral fascial breast restoration with implants. The fat and fascia tissue were well reserved to give a satisfying coverage of the appropriate implant. Negative pressure drainage and moulding dressing were used after the surgery.Results:Ten breast augmentation and restoration with a mean implant size of 200 cc (range, 180-300 cc). Less immediate postoperative pain and bleeding were reported. Patients were followed up for an average of 10 months (range, 6 to 21 months). There were no cases of major malpositions, double-bubble and bottom out symptoms. The overall outcome was with better symmetry and satisfaction with time passed by, and no secondary surgical procedures needed.Conclusions:Primary and satisfactory results have been obtained in subfascial breast augmentation and restoration for indications. With the endoscopic-assisted accurate pectoral fascial dissection, and well reserved soft tissue coverage, this technique could avoid the pectoralis major muscle ablation and keep the advantages of sub-glandular plane.

Objective:To investigate the application effect of reverse abdominal wall advancement flap in repairing chest wall soft tissue defect after breast tumor resection.Methods:From October 2020 to April 2021, the Department of Plastic Surgery and Breast Surgery of Hainan Cancer Hospital cooperated to repair the chest wall wounds of 4 female patients with unilateral giant breast tumors after primary lesion resection. Patients aged 40-63 years old, with an average of 51.5 years old. The size of the tumor estimated by physical examination was 7 cm × 6 cm-15 cm × 20 cm. The flaps were closely monitored after surgery, and complications were recorded. Local recurrence was followed-up.Results:The wound size of 4 patients after mastectomy was 16 cm×14 cm-20 cm×18 cm. Abdomen separation range reached anterior axillary line laterally and contralateral clavicle midline medially. Inferiorly, 1 case reached umbilical level, 1 case reached 2 cm below the umbilicus, and 2 cases reached 3 cm below the umbilicus. Three cases were diagnosed as breast lobulated tumors, and 1 case invasive lobular carcinoma. Among the 4 cases, 3 flaps survived completely and healed by first intention, while another flap healed under blister scab. There was no necrosis, infection, hematoma, seroma, or vascular crisis of the flap. All patients were satisfied. Three patients received radiotherapy and one received radiotherapy combined with oral chemotherapy. All patients were followed up for 3-6 months. No local recurrence was discovered. The abdomen was tighter than before operation, but no stiffness was found. There was no abdominal pain, abdominal wall bulging or abdominal hernia.Conclusions:Reverse abdominal wall advancedment flap was used to repair soft tissue defect of the chest wall after breast tumor resection. The operation was simple and fast, with no need for additional donor site incision. Quick recovery allowed shorter interval between surgery and next scheduled treatments.