Objective To investigate apoptosis of placental syncytiotrophoblast in patients with early-onset and late-onset severe preeclampsia. Methods From November 2008 to May 2009, 15 cases with early-onset severe preeclampsia and 15 cases with late-onset severe preeclampsia matched with 10 women with normal pregnancies as control at Sixth Affiliated Hospital of Shanghai Jiaotong University were enrolled in this study. Enzyme-linked immunosorbent assay was used to measure syncytiotrophoblast microparticles (STBM) levels in peripheral venous plasma. Caspase-3 were measured by western blotting.Results (1)STBM: the level of STBM of (71 ± 21 )μg/L in early-onset group were significantly higher than (42 ±30)μg/L in late-onset group and (26 ± 11)μg/L in control group(P ＜0.05). The level of STBM in late-onset group and control group did not reach statistical difference ( P ＞ 0. 05 ). ( 2 ) Caspase-3:the level of caspase-3 protein were 0. 85 ± 0. 61 in early-onset group and 0. 77 ± 0. 46 in late-onset group,which were all significantly higher than 0. 32 ± 0. 15 in control group( P ＜ 0. 05 ). However, the level of caspase-3 protein in early-onset group did not show remarkable difference compared with that in late-onset group (P＞0. 05). Conclusion STBM are shed into the maternal circulation in higher amounts in earlyonset preeclampsia, which indicated that early-onset and late-onset severe preeclampsia may have different etiology and pathogenesis.

Objective To explore the clinic effects in duplication blepharoplasty with the multiple tiny inci- sions.Methods The line of drooping blepharon was set in routine in 183 patients,the incisions with 3～4mm long would be made in middle and the both canthi sides on the line,cutting 1.5～2mm long flaps of the muscle orbicularis oculi off in the down rim of the incisions.Excessive fats also released form the orbital septum in patients with swelling blepharon.Then put up the muscle tendon of blepharon and sutured with the slcin on the up rim of tarsal plate.Results The reaction of tissue after operation was very light,swelling in the incision could disappear after 7～23 days and the incision scars weretiny and unclear,tbe double-fold eyelids had a good appearance in long time.Con- clusion It is an effective and usable procedure to the patients without skin loosening or serious swelling blepharon by means of multiple tiny incisions in blepharoplasty.

Objective To explore the effects of glucocorticoid(GC)and lipid metabolism on the pathogenesis of avascular necrosis of femoral head(ANFH).Methods Thirty-two New Zealand rabbits were randomly assigned into two groups as experiment group(n=24)and control group(n=8).Each rabbit in experiment group was given injection with 8.0mg/kg of hydrocortisone acetate for two times per week,while rabbits in control group were given normal saline in same quantity.Serum glucocorticoid(GC)concentration,total cholesterol(TC)and triglyceride(TG)were determined respectively before and 2,4,6 and 8 weeks after treatment.Rabbits were sacrificed at the 2nd,4th,6th and 8th week.The rabbits,sacrificed at the same time point,were stratified into group A(low concentration group)and group B(high concentration group)according to the GC concentration,in an attempt to observe the rate of empty bone lacuna and glucocorticoid receptor(GR)expression in the soft tissue around hips.Results The concentration of TC of experiment group began to increase since the 6th week,and that of TG since 2nd week(P0.05).In addition,the rate of bone lacuna and OD scores of GR were positively correlated at the 4th and 8th week(r=0.699 0,0.605 0,P

Objective To study the intercellular adhesion molecule-1(ICAM-1)and fat metabolism in the contribution of the incidence of steroid avascular necrosis of femoral head(ANFH).Methods 32 New Zealand rabbits were randomly divided into two groups:animals in experiment group(n=24)were given an injection of hydrocortisone acetate(8.0mg/kg)two times per week,and animals in control group(n=8)were given an injection with the same volume of normal saline.Serum total cholesterol(TC),triglyceride(TG)and ICAM-1 were quantitated before and 2,4,6,8 weeks after the treatment.2,4,6 and 8 weeks after treatment,6 animals of the experiment group and 2 of the control group were randomly chosen and sacrificed.ICAM-1 expression in soft tissue around hip was determined immunohistochemically,and pathohistological changes in femoral head were observed by light microscopy.Results Serum TC and TG levels of the animals in experimental group were significantly higher than those before treatment and those in control group in the 6th week after treatment(P

Objective To investigate the distribution of interstitial Cajal-like cells(ICLC) in ampulla and the myoelectric activities of the sphincter of Oddi(SO) of adult guinea-pigs.Methods C-Kit immunohistochemical staining was carried out on whole-mount preparations of guinea-pigs' ampulla region.The myoelectric activities of SO were recorded by using the contact electrode on mucosa.Result C-Kit-positive ICLC were observed in both exterior and inner wall of ampulla.Some of these cells were distributed in the circular and longitudinal smooth muscle cell(SMC) layers assuming a spindle-like shape.Another sub-group of ICLC,which were located between the longitudinal and circular SMC layers,were shown to have oval or triangle cell bodies with projection of more than three long processes.These cells interlaced into a cellular network,closely resembling the interstitial cells of Cajal(ICCs),around the myenteric nervous plexus(ICC-MY) in the duodenum.At the inner side of circular SMC layer of the exterior wall,ICLC were similar to ICCs associated with the deep muscular plexus(ICC-DMP) of small intestine.In the inner wall of the ampulla,a large amount of ICLC were found in the SMC layers or bundles,running parallel with them.At the opening of the ampulla,a number of ICLC surrounded the opening to form a ring.The spontaneous rhythmic myoelectric activities could be recorded in the SO.Conclusion It is suggested that the ICLC might contribute to the regulation of the spontaneous rhythmic contraction,and it might be related to development of motility disorders of the SO.

Coronary fistulae and ventricular septal perforation are very rare clinically, and even less caused by cardiac leiomyosarcoma. A case is reported that a 67-year-old female had cardiac leiomyosarcoma with progressive heart failure and coronary fistulae and ventricular septal perforation. This case was special since all ante-mortem examinations and cardiac surgery failed to detect the presence of any abnormal car-diac mass. Therefore, the malignant cardiac tumors could appear in an invasive form without mass and be one of the causes of the coronary fistulae and ventricular septal perforation.

To design an inpatient charging management system to optimize the patient accounting flow. The problems in all links were analyzed, and auditing mode and flow were modified. Under the existing HIS, the sys-tem was developed with added datasheets, determined elements, desired rules, .Net framework and C# language. The system made the prescription linked with the charging so that the doubtful items could be marked automatically. The system facilitates the fee auditing, shortens the waiting time of the patient, enhances the communication between the departments and promotes the quality of medical records.

Objective:To analyze the rationality of off-label drug use in nephritic syndrome prescriptions to provide scientific basis for clinical rational drug use and further regulate the off-label drug use in our hospital. Methods:Totally 1 908 outpatient prescriptions of nephritic syndrome selected from our hospital during November 2014 to April 2015 were analyzed, and all the off-label drugs were listed . The rationality of the off-label drug use was analyzed and evaluated by searching the related kidney disease guidelines and litera-tures. Results:The off-label drug use of tacrolimus capsules, mycophenolate mofetil capsules, cyclophosphamide for injection, ciclos-porin soft capsules, dipyridamole tablets, hydroxychloroquine sulfate tablets and warfarin sodium tablets were recommended by domes-tic and overseas guidelines with better evidence of evidence-based medicines. Tripterygium glycosides tablets and leflunomide tablets were supported by the literatures on clinical studies at home and abroad. The above 9 kinds of off-label drugs were rational drug use. Lumbrokinase enteric-coated capsules, salvia miltiorrhiza and ligustrazine injection and pidotimod dispersible tablets were reported only by a handful of journals. Bacteria lysate capsules and boric acid powder had no related information support, which belonged to the em-pirical prescriptions of physicians. The above 5 kinds of off-label drugs were not rational drug use. Conclusion:It is a widely existing phenomenon that the medication in nephrotic syndrome is beyond the instruction, the most of off-label drug use are reasonable, and cli-nicians should prescribe medicines carefully. Our hospital needs to further standardize the management of off-label drug use supported by higher evidence in order to improve the level of clinical rational drug use and the reasonable rate of prescriptions.

Objective: To quantitatively analyze the content of glucose in glucose injection by near infrared spectroscopy to control the quality of the product.Methods: A quantitative model was established by near infrared reflectance spectroscopy and the injection came from pharmaceutical enterprises with different concentrations of glucose and the solution samples came from laboratories with different concentrations of glucose.The liquid sample accessories were selected, a quantitative model was established by a partial least squares method, and the effect of environmental temperature on the model was studied as well.Results: According to the quantitative model, the correlation coefficient reached up to 0.999 3, and RMS deviation (RMSECV) was 0.077 4.In the verification test, the results of various liquid formulas containing glucose were similar to those of the laboratory results.The prediction error was less than 5% within the temperature range of 20-35℃.Conclusion: The model of near-infrared partial least squares (PLS) can accurately predict the content of glucose in glucose products without sodium chloride, and can be used for the quality control of glucose intermediates and the finished products in the large infusion manufacturers