Spontaneous abortion is one of the most common complications of pregnancy， and two or more spontaneous abortions in a row are defined as recurrent spontaneous abortion （RSA）， of which about half of patients have unknown etiology. However， the pathogenesis of unexplained RSA （URSA） has not been elucidated， and the lack of effective treatment has made it one of the key and difficult points in the field of obstetrics and gynecology. This article conducts a literature review of recent research on URSA and finds that the pathogenesis of URSA is related to the imbalance of immune tolerance at the maternal-fetal interface， apoptosis of trophoblast cells， inhibition of angiogenesis， and activation of immune responses. Immunotherapy （including cell therapy， cytokine therapy， and immunosuppressive intervention）， hormone drugs， anticoagulant regimens， and traditional Chinese medicine therapies are commonly used in clinical practice to intervene in URSA， but the safety and effectiveness of some therapies are still controversial.

Alzheimer's disease (AD) is the first degenerative disease of the nervous system, but no drugs have been found to reverse AD progression. Starting from 2 major pathogenesis of AD, namely amyloid beta (Aβ) cascade and Tau protein, this study systematically reviews anti-Aβ or Tau protein AD new drugs that have entered clinical research; this study also expounds their clinical trial findings and mechanisms, and analyzes the reasons for their success or failure to provide a theoretical basis for AD drug exploitation.

Recent studies have found that the pathological changes of Tau proteinopathy, such as Alzheimer's disease (AD) and progressive supranuclear palsy (PSP), involve transmission or circulatory disturbance of synaptic vesicles. This article reviews the relations of AD/PSP with circulatory disturbance of synaptic vesicles and explore the pathogenesis of these diseases, aiming to provide a new perspective for new therapeutic drugs.

Objective To discusse the influence of permeating perfluoropentane drops-encapsulated mesoporous silica nanocapsules (MSNC-PFP) on HIFU surface ablation in vitro bovine liver.Methods Fifity bovine liver tissues were divided into 5 groups:Control group,0.25 mg/ml group,0.50 mg/ml group,1.00 mg/ml group,2.00 mg/ml group according to the concentration of MSNC-PFP.The synergistic agent was injected along the ablation line path under the guiding of ultrasound.The surface ablation model was structured by 6 coagulation necrosis side by using HIFU linear scanning,inner region without melting,and the ultrasonographic changes were observed in the melt area.The coagulation necrosis range was assessed by TTC staining,and necrosis degree was observed by HE staining.The coagulation necrosis volume was measured,the coverage index (CI),external volume index (EI),energy efficiency factor (EEF) were used to evaluate the ablation effect in each group.Results The MSNC-PFP more than 1.00 mg/ml was shown as strong echo in ultrasonic image,fade after 3-5 min.The grey value was changed in HIFU ablation area related to the concentration of MSNC-PFP.The total ablation volume of 0.50 mg/ml group,1.00 mg/ml group,2.00 mg/ml group were more than control group,the EEF was lower than that of the control group (all P＜0.01).The CI and EI of 1.00 mg/ml group and 2.00 mg/ml group were higher than those of the other group (all P＜0.01).The coagulation necrosis became complete when the concentration of MSNC-PFP above 0.50 mg/ml.Conclusion MSNC-PFP can increase the volume of coagulation necrosis,decrease the EEF and increase the efficiency of HIFU surface ablation of bovine liver in vitro.

OBJECTIVE: To compare the auditory steady-state response (ASSR) test data of severe sensorineural hearing loss children with cochlear lesion and those with retrocochlear lesion and find some specific phenomena of retrocochlear lesion in ASSR, then to improve diagnostic accuracy in clinical practice. METHOD: Between 2008 to 2012. 96 children (179 ears) were diagnosed with "retrocochlear auditory nerve lesion" and recieved ASSR test (" retrocochlear lesion" group). Eighty-one (143 ears) the same age children (143 ears) were diagnosed as "cochlear auditory nerve lesion" and selected them as the "cochlear lesion" group. Twenty-six (50 ears) normal hearing children at the same age who had ASSR test records selected from the pediatric hearing center database of our hospital were selected as "normal control" group. Compare the difference of ASSR threshold, ASSR elicit rate and ASSR audiogram among the three groups. RESULT: (1) ASSR threshold: Compared each frequency threshold in ASSR test with cochlear.lesion group, the retrocochlear lesion group with wave V and wave I had no significant difference in 500 Hz and 1000 Hz but had significant difference in 2000 Hz and 4000 Hz. As for the retrocochlear lesion group without wave V and wave I, there was a decline in 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz compared with cochlear lesion group. (1) ASSR elicit rate: When compared to retrocochlear lesion group, the cochlear lesion group had a significance lower elicit rate in the four frequency. (3) Number of elicit reactions in ASSR test . In the retrocochlear lesion group, the elicit reactions in all the four frequency in ASSR test was significantly higher than ochlear lesion group. (4) ASSR audiogram type. The proportion of rising curve audiogram in retrocochlear lesion group was 26.83% (with wave I and wave V), 40% (with wave I and without wave V ) and 33.80% (without wave I and wave V). CONCLUTION (1) Children with a severe hearing loss in ABR test and a rise type audiogram in ASSR test should be most possibly considered as retrocochlear lesion. (2) ASSR threshold cannot be used in determinate the severity of hearing loss in children with retrocochlear lesion.
Auditory Threshold ; Child ; Cochlea ; pathology ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Tests ; Humans ; Labyrinth Diseases ; Vestibulocochlear Nerve Diseases ; diagnosis

Objective To explore the ultrasonographic characteristics of internal jugular vein(IJV) valve insufficiency and reflux.Methods 40 healthy volunteers' bilateral IJVs were study subjects.The inner diameter,valve morphological feature,reflux distance and hemodynamic parameters in IJV were detected by color Doppler ultrasound (CDU),the contrast agents transvalvular regurgitation in IJV was monitored by contrast-enhanced ultrasound (CEUS) (with low mechanical index,MI 0.10),then analyse the results of two methods.Results Of 80 investigated IJVs,1 vein was excluded due to absence of its left valve,so 79 veins were evaluated in the study.The IJV's inner diameter on the right side was larger than on the left side,but there was no significant difference (P ＞0.05).The detection rate of IJV valve insufficiency was 31.6％ (25/79),which was higher on the right than that on the left,but without significant difference (P ＞ 0.05).The detection rate of IJV valve insufficiency was significantly higher in the group of greater than or equal to 50 years old than that in less than 50 years old(P ＜0.05).The reflux distance in IJV displayed by CDU was associated with IJV valve's function.Compaired with sufficient valves,the reflux duration time in insufficient valves during quiet respiration showed no significant difference (P ＞0.05).During Valsalvalike manoeuvres and quiet respiration,the reflux duration time in sufficient valves showed no significant difference (P ＞ 0.05).The reflux duration time in insufficient valves during Valsalva-like manoeuvres showed significantly higher than that during quiet respiration (P ＜0.01).Compaired with sufficient valves,the peak flow velocity of reflux flow in insufficient valves was significantly prolonged during quiet respiration and Valsalva-like manoeuvres (P ＜0.05,P ＜0.01,respectively).Conclusions The incidence rate of IJV valve insufficiency and reflux is high in healthy individuals.During quiet respiration and/or Valsalva-like manoeuvres,detecting the reflux distance,reflux duration time and peak flow velocity of reflux flow by CDU are valuable in evaluating IJV valve insufficiency and the degree of IJV reflux.

OBJECTIVE: To study the characteristics of infants middle ear function of children (0-1 year old) with 226 Hz, 1000 Hz tympanometry. METHOD: Tympanometric data using 226 Hz, 1 000 Hz probe tones were gained from 150 children (300 ears) aged 0-1 year old with a GSI tympstar middle ear analyzer. All of them were term birth, divided into 5 groups of 30 patients, the neonatal period (0-28 days), 6 weeks (+/- 3 days), 3 months (+/- 6 d), 6 months (+/- 6 days), 7-12 months. To analyse the middle ear function of children with 226 Hz, 1000 Hz tympanometric data. RESULT: 226 Hz,1000 Hz probe tone tympanometric data were normal for the normal group, which respectively were: 76.7%, 80%, 86.7%, 90%, 93.3%. 226 Hz, 1000 Hz detection tympanometric data were not sound normal to abnormal group, the proportion in each group were: 13.3%, 8.3%, 5.0%, 3.3%, 1.6%. The contradiction between the two groups were divided into two subgroups: 226 Hz normal, 1000 Hz unusual in the proportion of each group were 6.7%, 6.7%, 5.0%, 3.3%, 1.6%; 1000 Hz normal, 226 Hz unusual in the proportion of each group were 5.0%, 5.0%, 3.3%, 3.3%, 3.3%. CONCLUSION The sensitivity and specificity of the 1000 Hz probe tone tympanometry was better.
Acoustic Impedance Tests ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Sensitivity and Specificity

OBJECTIVE: To evaluate the characters and hearing changes of the infants failed in hearing screening with high-risk factors for hearing loss. METHOD: Two hundred and forty-four infants (488 ears) who failed in the hearing screening or with the different results between the first and second screening, were tested by auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement in this study. RESULT: (1) A little proportion results among the three DPOAE screening was variable, the pass rate in the right-ear was higher than that in the left-ear. (2) Forty-five of 184 ears which had passed the third DPOAE evaluation had the abnormal ABR results, the discrepancy rate between the two methods was 24.5% (45/184); 20 of 304 ears which failed in the hearing screening had a normal ABR results, with the discrepancy rate of 6.6% (20/304). (3) The highest proportion of abnormal result of the ABR in each groups was mild hearing loss, normal ABR in each groups also had a large proportion. The proportion of moderate hearing loss in the group of no more than three months old infants was significantly increased compared with the other two groups (P < 0.01), and no significant difference of severe hearing loss among the three groups (P > 0.05). (4) More than 70% of type A tympanogram was found in each groups (P > 0.05), the ratio of type B in moderately abnormal group was higher than other groups. Type C was only detected in one ear with severe hearing loss. (5) 29.5% infants had suffered the hyperbilirubinemia, which was much higher than the other risk factors (P < 0.05). CONCLUSION The hearing loss of infants with high-risk factors are mostly mild, and show some indication of fluctuating. Some moderate hearing loss have the tendency to changes better. The combined use of electrophysiological measures can improve the accuracy of hearing evaluation.
Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss ; diagnosis ; physiopathology ; Hearing Tests ; Humans ; Infant ; Infant, Newborn ; Male ; Neonatal Screening ; methods ; Otoacoustic Emissions, Spontaneous ; Risk Factors

Objective:To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics. Method: Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies. Result:The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave Ⅰ,Ⅲ and Ⅴ latencies Ⅰ-Ⅲ ,Ⅲ-Ⅴ and Ⅰ-Ⅴ intervals and postconceptional age. Wave Ⅰ and Ⅴ latencies, Ⅰ-Ⅲ and Ⅲ-Ⅴ intervals differed significantly between the two groups. Conclusion:The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.

Objective:To investigate the characteristic and the hearing change of hearing thresholds of the infants failing in the hearing screening.Method:802 infants(1179 ears) with hearing screening record were reviewed in the study. They had hearing screened by otoacoustic emissions (OAE).However, they failed in the first or & and second hearing screening. Auditory brainstem response (ABR) , distortion product otoacoustic emissions(DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following 1-3 months (before 6-month-old). To analysis the characteristic and the hearing change of hearing thresholds of the tests.Result:Among 802 cases(1179 ears),the ratio of single-ear(53.2%) is higher than both-ears(39.5%), P<0.05. And there are no significance between the two groups in the ration of severe abnormal hearing-evaluation ;25.8% infants once suffered from hypercholesterolenia failed in the hearing screening,which was higer than the other known risk factors.P＜0.05; Threatened abortion group has found no cases of severe hearing abnormalities; The ratio of severe abnormal hearing-evaluation in family history hearing loss group (40.9%) was higher than other high-risk factors, followed by two or more risk fators group(10.8%);56.9% of the infance who did not pass the hearing screening were found none risk factors, 42.3% of the infances who had high risk factors was normal hearing level;96 cases(138 ears) undergone twice assesement, in morderat disorder group, more cases(74.3%) changed better , and less disorder group(40.9%), severe disorder group (33.3%).Seven ears became worse; Among abnormal hearing induced by different high-risk factors, the proportion of hearing improvement in children with moderate abnormal hearing was higher than that in children with slight abnormal hearing. Ten cases(12 ears) diagnosised auditory neuropathy.Conclusion:The important factors make the follow-up decision incluing perinatal history,hearing level and age.Maybe some high-factors we did not realized. Gene screening should be paied more attention in the future work.