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ObjectiveTo explore effect of modified Wuhutang on airway inflammation and expression of mucin （Muc） 5AC， signal transducer and activator of transcription 3 （STAT3）， nuclear factor kappa B （NF-κB）， and NOD-like receptor thermal protein domain associated protein 3 （NLRP3） in respiratory syncytial virus （RSV）-infected asthmatic mice. MethodSeventy male BALB/c mice of 6-8 weeks old were randomized into normal control （CON）， asthma （ovalbumin， OVA）， RSV infection-induced asthma （OVA+RSV）， high-， medium-， and low-dose （4.08， 2.04， 1.02 g·kg-1·d-1， respectively） modified Wuhutang， and dexamethasone （Dxms， 0.1 g·kg-1d-1） groups （n=10）. The model of asthma was established by sensitization and atomization inhalation with OVA. The RSV infection-induced asthma model was established by three consecutive RSV nasal infusions （1.0 × 106 PFU·mL-1， 50 μL）. Wuhutang was administrated by gavage， and Dxms by intraperitoneal injection. The CON group was given the same amount of normal saline by gavage. The mice were anesthetized with 2.5% pentobarbital sodium 24 h after the last administration， and then the lung tissue was stained by hematoxylin-eosin （HE） and Van Gieson （VG） for observation of airway inflammation. The immunohistochemical assay was employed to detect the expression of Muc5AC. Western blot was employed to determine the protein levels of phosphorylated （p）-STAT3， STAT3， p-NF-κB， NF-κB， and NLRP3. ResultCompared with the CON group， the OVA group presented airway inflammatory cell infiltration， tissue hyperemia and edema， and collagen fiber deposition. The OVA+RSV group showed severer airway inflammatory cell infiltration and tissue hyperemia and edema than the OVA group. Compared with the OVA+RSV group， modified Wuhutang alleviated the airway inflammatory cell infiltration， tissue hyperemia and edema， and collagen fiber deposition， and the high-dose group had the best performance. Compared with the CON group， the OVA group and the OVA+RSV group showed increased expression level of Muc5AC （P<0.01）. Compared with the OVA+RSV group， modified Wuhutang reduced the expression level of Muc5AC， and the reduction was significant in the high-dose group （P<0.05）. Compared with the high-dose modified Wuhutang group， Dxms lowered the expression level of Muc5AC （P<0.05）. Compared with the CON group， the OVA and OVA+RSV groups showed up-regulated protein levels of p-STAT3， p-NF-κB， and NLRP3 （P<0.05， P<0.01）. Compared with the OVA+RSV group， modified Wuhutang down-regulated the protein levels of p-STAT3， p-NF-κB， and NLRP3 （P<0.01）. Compared with the high-dose modified Wuhutang group， the Dxms group showed up-regulated levels of p-STAT3， p-NF-κB proteins （P<0.01）. ConclusionModified Wuhutang can reduce airway inflammation and down-regulate the expression of Muc5AC， p-STAT3， p-NF-κB， and NLRP3 in RSV-infected asthmatic mice， which suggests that Wuhutang reduces airway inflammation in RSV-infected asthma by regulating the STAT3/NF-κB signaling pathway.
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Ferroptosis, a new form of programmed cell death, could be regulated by lipid metabolism, amino acid metabolism, and iron metabolism. Ferroptosis is closely related to human physiological mechanisms and involved in the development and progression of multiple diseases. More and more researchers have found that ferroptosis also plays a vital role in pregnancy-related disorders such as preeclampsia, gestational diabetes, and miscarriage. However, the mechanisms have not yet been fully understood. This article reviews the progress in ferroptosis in pregnancy-related diseases to provide new directions for scientific research and clinical treatment.
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Objective To investigate the incidence of cognitive dysfunction in postpartum women who underwent epidural or non-drug labor analgesia and the influence factors.Methods A prospective cohort study was performed in 1 618 uneventful singleton pregnancies in International Peace Maternity and Child Health Hospital from January 2017 to January 2018.Women who received epidural labor analgesia were assigned to the epidural group (n=803),and those who received Doula technique non-drug labor analgesia rather than labor analgesia to the control group (n=815).Cognitive function was assessed using symbol digit modalities test (SDMT90) and Montreal cognitive assessment (MoCA) 1 d and 42 d after delivery.Incidence of maternal cognitive dysfunction,SDMT90 scores and pain intensity measured by visual analogue score (VAS) at the cervical dilatation of 3,6 and 10 cm between the two groups were compared using independent sample t-test,Chi-square test or logistic regression analysis.Results MoCA and SDMT90 scores of the epidural group were significantly higher than those of the control group 1 d after delivery (27.1 ± 1.5 vs 26.2± 1.8,49.1 ±2.4 vs 42.5 ± 3.6;t=3.775 and 16.956,both P＜0.05),but the incidence of postoperative cognitive dysfunction (POCD) in the epidural group was remarkably lower comparing to the control group [13.9％ (112/803) vs 21.2％ (173/815),x2=14.769,P=0.002].The VAS scores of the epidural group at the cervical dilatation of 3,6 and 10 cm were all lower than those of the control group (2.3 ± 0.6 vs 6.9± 1.3,3.3 ± 0.9 vs 8.7± 0.9,5.7± 0.9 vs 9.7± 0.4;t=0.013,0.011 and 0.015;all P＜0.001).Logistic regression analysis indicated that VAS scores ≤ 3 at the cervical dilatation of 3,6 and 10 cm were protective factors against the incidence ofPOCD 1 d after delivery [OR(95％CI):0.238 (0.198-0.287),0.180 (0.145-0.222) and 0.112 (0.088-0.142),all P＜0.001],while the absence of epidural labor analgesia was a risk factor (OR=4.698,95％CI:1.812-11.321,P＜0.001).Conclusions Epidural labor analgesia can reduce the incidence of postpartum cognitive dysfunction in women 1 d after delivery.The incidence of POCD has close relationship with the VAS scores at the cervical dilatation of 3,6 and 10 cm and epidural labor analgesia.
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Preeclampsia is an idiopathic gestational disease with unknown etiology or pathogenesis. Exosomes are membranous nanovesicles secreted by various cells, carrying contents such as proteins, mRNA, microRNA and lipids and being involved in regulations between cells by transporting the above contents through target cells. The expression of exosome-derived proteins and microRNAs in preeclampsia patients experiences changes, resulting in maternal inadequate trophoblast invasion, depressed endothelial cell function and angiogenesis. Research on placenta-derived exosomal microRNAs in preeclampsia patients may help to elucidate the pathogenesis of preeclampsia.
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Acute mixed-cell leukemia (MPAL) is a rare high-risk leukemia that may originate from pluripotent hematopoietic stem cells.At present,the pathogenesis of MPAL is not clear,which mainly relys on immunophenotyping and molecular genetic diagnosis. Allogeneic hematopoietic stem cell transplantation may be the only way to cure the disease, depending on the immunophenotype and genetic characteristics of the leptin and/or myeloid induction chemotherapy. The prognosis of MPAL is worse than that of other acute leukemia, and understanding of these phenotypic genetic related clinical changes, biological significances and its pathogenesis will help to prevent and treat this disease effectively.
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Acute mixed-cell leukemia (MPAL) is a rare high-risk leukemia that may originate from pluripotent hematopoietic stem cells.At present,the pathogenesis of MPAL is not clear,which mainly relys on immunophenotyping and molecular genetic diagnosis. Allogeneic hematopoietic stem cell transplantation may be the only way to cure the disease, depending on the immunophenotype and genetic characteristics of the leptin and/or myeloid induction chemotherapy. The prognosis of MPAL is worse than that of other acute leukemia, and understanding of these phenotypic genetic related clinical changes, biological significances and its pathogenesis will help to prevent and treat this disease effectively.
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Objective To evaluate value of narrow band imaging(NBI) endoscopy for children with abdominal Henoch?Schonlein purpura ( HSP ) . Methods A total of 46 patients with abdominal HSP were enrolled into the observation group(NBI intervention) from November 2010 to February 2016.Diagnostic rates of white light and NBI endoscopy in abdominal HSP patients, IgA positive rates of targeted biopsies and severe complications were retrospectively analyzed. A total of 25 abdominal HSP patients with no NBI intervention admitted from 2007 to 2009 were randomly enrolled into control group. Data of the control group were compared with those of observation group. Results In observation group, the diagnostic rate under NBI was significantly higher than that under white?light endoscopy[91. 3%(42/46)VS 67. 4%(31/46),χ2=8. 02,P<0. 05]. IgA positive rates of targeted biopsies under NBI was significantly higher than that under white?light endoscopy [ 95. 7%( 88/92 ) VS 69. 6%( 64/92 ) ,χ2 = 21. 79, P<0. 05 ] . Three patients developed such serious complications as digestive hemorrhage as predicted. Compared with control group, abdominal pain and blood stool relief time (10. 96±5. 32 d VS 19. 68±4. 29 d,t=7. 50,P<0. 01), fasting time(10. 37±5. 42 d VS 8. 80± 3. 71 d,t=7. 73,P<0. 01), hospital stay (18. 80±7. 11 d VS 23. 12±4. 36 d, t=3. 16,P<0. 01), time of stool occult blood negative ( 11. 41 ± 6. 30 d VS 19. 12 ± 4. 09 d, t=6. 22, P<0. 01 ) in observation group were significantly shortened. Conclusion NBI endoscopy is valuable for improving the diagnostic accuracy and biopsy accuracy and complication prediction of abdominal Henoch?Schonlein purpura in children.
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Objective To investigate the optimal gestational weight gain (GWG) in twin pregnancies and to analyze the impact of GWG on pregnant outcomes.Methods A retrospective cohort study of twin pregnancies was conducted on women who gave birth in International Peace Maternity and Child Health Hospital,Shanghai Jiaotong University School of Medicine from January 1,2012 to the June 30,2015.An optimal range of GWG was calculated based on the amount of weight gain in 711 subjects who gave birth to normal twins and with uncomplicated pregnancy.Another 504 twin pregnant women without gestational complications were recruited for further analysis of the relationship between GWG and gestational outcomes.T-test,analysis of variance and Chi-square test were used for statistical analysis.Results (1) The optimal range of GWG for full-term twin-pregnancy was 15.3-21.4 kg.In those with low body mass index (BMI,＜18.5),normal BMI (≥ 18.5-＜25.0) and overweight/obesity (≥ 25.0),the GWG [M(P25-P75)] were 18.5 (15.8-22.2),18.3 (15.3-21.3) and 18.1 (14.9-21.5) kg,respectively.There was no significant difference in GWG among those groups (F=0.121,P=0.886).(2) According to the optimal GWG mentioned above,we divided the 504 cases into three groups,including lower GWG group (less than the optimal GWG,n=137),normal GWG group (in the GWG range,n=238) and higher GWG group (more than the optimal GWG,n=129).The neonatal birth weights in the three groups were (2 626.1 ±225.8),(2 680.14-237.9) and (2 751.9±257.1) g (F=9.189,P＜0.01),respectively,indicating that neonatal birth weight was increased by increasing GWG.The proportion of both twins with birth weights of more than 2 500 g was slightly increased,but there was no significant difference among the three groups [51.1 ％ (70/137),60.5％ (144/238) and 64.3％ (83/129),respectively,x2=5.279,P=0.071].The incidence of gestational diabetes mellitus (GDM) was reduced along with increased GWG [31.4％ (43/137),14.7％ (35/238) and 9.3％ (12/129),respectively,x2=25.144,P＜0.01],while the incidence of hypertensive disorders in pregnancy (HDP,including gestational hypertension and preeclampsia) in the three groups showed no significant difference.There were 90 cases (17.8％) of GDM in the 504 cases with a pre-pregnancy BMI of 22.5±2.8,which was higher than that of the non-GDM cases (21.21±2.9),(t=3.735,P＜0.01).Among the 504 cases,there were 67 cases (13.3％) of HDP (including gestational hypertension and preeclampsia) with a pre-pregnancy BMI of 22.4±2.8,which was higher than that of the non-HDP patients (21.3 ± 2.9,t=2.767,P=0.006).Conclusions The pre-pregnancy BMI has little influence on GWG in twin pregnancies.Increasing GWG to the recommended optimal range or above,and within a certain range,could promote an increase in neonatal birth weight without adding the risks of gestational complications,such as gestational diabetes mellitus,gestational hypertension and preeclampsia.
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Objective To investigate the relationship between gestational hypothyroidism and preeclampsia.Methods A retrospective study was conducted on 1 776 patients with gestational hypothyroidism,who gave birth in the International Peace Maternity & Child Health Hospital of China Welfare Institute,Shanghai Jiaotong University School of Medicine from January 2013 to December 2014.They were divided into three groups,including Improving Group (n=1 469),Progressing Group (n=133) and Remaining Group (n=174),based on their thyroid function at the first and third trimesters.Levels of thyroid hormones in the first and third trimesters were analyzed.Incidences of preeclampsia in those patients were calculated.And the correlation between thyroid function and incidence of preeclampsia was analyzed.T-test,Mann-Whitney U test,Chi-square test,variance analysis (SNK method) and Kruskal-Wallis H test or Logistic regression were performed for statistical analysis.Results (1) There were no statistical differences in age,gravidity and parity among the three groups.The pregestational body mass index in Progressing Group was lower than that in Improving group (21.1 ±2.9 vs 21.8±2.8,P＜0.05).(2) In the first trimester,the level of thyroid stimulating hormone (TSH) in Remaining Group was higher than those in Improving and Progressing Groups [(4.21 ± 1.69) vs (3.77±.3.03) and (2.00±0.57) mU/L,F=27.635,P＜0.01],and that in Improving Group was higher than that in Progressing Group (P＜0.05).The level of free thyroxine (FT4) in Progressing Group was higher than those in Improving and Remaining Groups [(16.18±9.67) vs (14.58± 1.71) and (14.54± 1.74) pmol/L,F=16.188,P＜0.01].In the third trimester,the TSH level in Remaining Group was higher than those in Improving and Progressing Groups [(5.07±0.86) vs (2.57±0.77) and (4.31 ±0.87) mU/L,F=28.986,P＜0.01],while the TSH level in Improving Group was higher than that in Progressing Group (P＜0.05).No statistical differences in FT4 levels (in the third trimester) and positive rates of thyroid peroxidase antibody (TPOAb) Were observed in the three groups.(3) Blood pressures (including diastolic and systolic blood pressures) in the first trimester and diastolic pressures in the third trimester showed no significant differences among the three groups.Systolic pressure of Improving Group in the third trimester was lower than that of Progressing Group [(119.4± 11.9) vs (121.8± 14.2) mmHg,P＜0.05,1 mmHg=0.133 kPa].(4) The incidence of preeclampsia in Progressing Group was higher than those in Improving and Remaining Groups [7.52％ (10/133) vs 1.29％ (19/1 469) and 3.45％ (6/174),x2=26.646,P＜0.01],and the incidence in Progressing Group was higher than those in Remaining and Improving Groups (both P＜0.05).The incidence of severe preeclampsia in Progressing Group was higher than that in Improving Group [6.02％ (8/133) vs 0.41％ (6/1 469),P＜0.05].There were no significant differences in incidences of mild preeclampsia among the three groups.(5) After adjusting for age,body mass index,gravidity and parity,the risk of severe preeclampsia in Improving Group was lower than that in Remaining Group (OR=0.233,95％CI:0.057-0.946,P＜0.05).Conclusions By improving thyroid function in pregnant women with hypothyroidism,the risk of preeclampsia,especially severe preeclampsia,could be reduced,which could improve maternal and neonatal outcomes.
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Objective To investigate the complications and management of nitinol self-expandable metal stent (cSEMS) in treatment of refractory esophageal strictures in children. Methods The clinical data were reviewed for 9 pediatric patients with refractory benign esophageal disorders from May 2009 to December 2016, specially designed cSEMS were applied to them, data about effects and complications were collected during regular follow-ups. Results Successful cSEMS placement was performed in 9 children, the symptom of dysphagia was obviously alleviated after implantation, all patients underwent vomiting and chest pain 1~7 days after operation; 1 case could not put up with the pain, so the stent had to be removed in 36 hours after implantation; 2 cases developed a recurrent stricture within 3 months after stent removal, growth of mild granulation tissue was found in 1 case; In the case with esophageal fistulas, migration and poor adherence to the esophagus was occurred in 3 days after implantation, then a new designed cSEMS with bigger proximal tip was planted in the same place 1 week later, 2 months after stent removed, fistula was healed. Conclusion Placement of cSEMS is safe and effective in treating pediatric patients with refractory esophageal stricture. However, complications associated with stent placement should not be ignored, individually designed stent and timely management of the complications are quite important in order to enhance clinical efficacy.
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Objective · To evaluate the association between the abnormal maternal serum markers of alpha fetoprotein (AFP), human chorionic gonadotrophin (hCG) and unconjugated estriol (uE3) in the second trimester screening and the adverse obstetric outcomes other than trisomy 21 (T21),trisomy 18 (T18) and open neural tube defects (ONTD), and to provide local data for supporting evidence based clinical managements. Methods · A retrospective cohort study was performed in the women who received second trimester maternal serum screening in the International Peace Maternal and Child Health Hospital between 2012 and 2014, with naturally conceived singleton pregnancies. Obstetric outcomes were followed up by searching electronic medical records within the hospital. Abnormal level of marker was defined as a MOM value ≥ 99th (P99) or ≤ 1st percentile (P1) of the overall screened population. Incidence of an adverse obstetric outcome was compared between the groups with abnormal markers and the control with all markers in normal. Results · ① A total of 25616 pregnancies were included in this study, in which 4526 were identified as having various adverse obstetric outcomes. Among them 4143 pregnancies were with isolated and 383 pregnancies were with co-occurring two or more adverse outcomes. ② When compared to pregnancies with normal levels of all three serum markers, pregnancies with decreased AFP or decreased hCG did not show associations with any adverse obstetric outcomes. However, pregnancies with increased AFP, increased hCG or decreased uE3 were at increased risk for a variety of abnormal pregnancy outcome. In 18 pregnancies with an outcome of fetal chromosomal abnormalities other than T21 and T18, 9 presented with either increased AFP, increased hCG or decreased uE3, with relative risk ratios of 13.33、35.00 and 59.00, respectively. ③ The performance of those markers tended to be improved in a subset of adverse obstetric outcomes, including low birth weight
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Objective To establish a loop-mediated isothermal amplification method for detection of Campylobacter jejuni.Methods Six sets of primers were designed to recognize Campylobacter jejuni specific gene hipO.One was selected as the optimal primer and its specificity and sensitivity to Campylobacter jejuni were evaluated by LAMP reaction in 60 minutes at 62℃.Results The results recorded by the turbidity meter showed that the sensitivity of LAMP with a detection limit of 6.97×102 copies/μl was ten times that of PCR.Conclusion LAMP is a potential and valuable method of detection of Campylobacter jejuni due to its rapidity,simplicity,low cost and accuracy.It is especially suitable for grass-roots medical units.
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Objective To find simple and effective methods of preservation for Achromobacter xylosoxidans bacteriophages.Methods The plaque forming unit( PFU) of surviving phages under different preservation conditions and temperatures at different time points was determined.Results and Conclusion The titers of phiAxp-1 and phiAxp-2 main-tained at the initial 1010 PFU/ml, and that of phiAxp-3 decreased slightly from 1011 PFU/ml to 1010 PFU/ml 16 months after the three Achromobacter xylosoxidans bacteriophages were stored in glycerol and dimethyl sulfoxide at -80℃, -20℃and 4℃.When stored in chloroform at 4℃for 16 months, the titers of all the three phages decreased slightly but were higher than at other temperatures (-80℃, -20℃, room temperature, and 37℃) .Thus these methods can effectively preserve Achromobacter xylosoxidans bacteriophages.
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Objective To evaluate the value of endoscopy with narrow-band imaging(NBI)for tar-geting biopsy of lesions in children with allergic colitis. Methods The colorectal lesions under the model of traditional white light imaging and NBI in children with allergic colitis were observed and recorded. The re-sults of biopsy under white light imaging and NBI were compared with postoperative pathological diagnosis. Results A total of 60 patients completed the study. Under NBI,47(78. 3%)rectal lesions,52(86. 7%) sigmoid colon lesions and 19(31. 7%)descending colon lesions were found. There were 21(35. 0%),25 (41. 7%),and 8(13. 3%)lesions in the transverse colon,ascending colon and iloececus,respectively. For the lesions in transverse colon and ascending colon,the detection rate under NBI was significantly higher than that under white light endoscopy[35. 0% VS 16. 7%(10/ 60),P0. 05;78. 3% VS 76. 7%(46/ 60),P>0. 05].There was no significant difference in ileo-cecus and descending colon[13. 3% VS 5. 0%(3/ 60),P>0. 05;31. 7% VS 28. 3%(17/ 60),P>0. 05]. The targeted biopsy results by NBI indicated that the ratio of EOS≥6/ HP was significantly higher than the biopsy results by white light imaging. Conclusion NBI is easy to operate and can discern the microcosmic structure which cannot be observed by the traditional endoscopy. It can provide higher diagnostic accuracy of allergic colitis. After suspicious lesions were found under conventional endoscopic check,NBI could be used to guide the targeted biopsy.
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Objective To summarize the effectiveness and security of endoscopic removal of foreign bodies of battery in the gastrointestinal tract in children.Methods We analyzed retrospectively the clinical data of 13 patients who swallowed foreign bodies including button cell and cylindrical battery.The 13 patients were treated in our hospital between July 2011 and April 2015,aged 19 months to 12 years.Results A total of 9 cases of foreign bodies in esophagus,including embedded in the first the esophageal stenosis in 4 cases,the second the esophageal stenosis in 3 cases,cardia in 1 case,and 4 cases of foreign body in stomach.We successfully removed 16 foreign bodies of the battery in endoscopy.No serious complications such as perforation,hemorrhaging happened during and after operation.Conclusion It is one relatively safe and effective method of diagnosis and treatment of endoscopic removal of foreign bodies of battery in gastrointestinal tract in children.
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Interactions between FMDV and cardiac cells are multifaceted and complex ,these interactions leads to pro-teins alterations in cardiac cells inevitably .To understand the pathogenesis of myocarditis after FMDV infection in mice ,the suckling mouse model for myocarditis induced by foot-and-mouth disease virus (FMDV) was established in this study .Suckling mice within 3 days old was selected to infect by FMDV .Myocarditis caused by FMDV in suckling mice was confirmed with clinical symptom monitor .The observation of Hematoxylin and eosin stain (H&E stain) and transmission electron microscopy (TEM) were performed after samples processing .According to conventional polymerase chain reaction (PCR) methods ,prim-ers of VP1 gene was designed ,synthesised and specific FMDV VP1 gene was amplified from the heart muscle of suckling mice . The results indicated that suckling mice appeared low spirit condition ,dyspnea ,and dull reaction within 36 hours after chal-lenge with FMDV .Infiltration of inflammatory cells and dissolution of myocardial fibers were observed with H&E stain and TEM .Special target gene of FMDV was amplified from the heart of infected group .Obvious inflammation in the heart of suck-ling mice caused by FMDV was observed .It's suggested that suckling mouse model for myocarditis induced by FMDV was es-tablished successfully ,which would lay the foundation for researches of myocarditis mechanism in young cloven-hoofed ani-mals .
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<p><b>OBJECTIVE</b>To assess the safety of repeated invasive prenatal diagnosis primarily due to failed culture of amniotic cells.</p><p><b>METHODS</b>Between January 2000 and October 2012, 167 cases required repeated invasive prenatal diagnosis among a total of 5304 amniocentesis cases. Clinical outcome and karyotypes were analyzed to calculate the rate of fetal loss.</p><p><b>RESULTS</b>For the 167 re-sampled cases, the indications have included failed amniocyte culture (121 cases), chromosome mosaicisms (23 cases), failed amniocentesis (21 cases), and request for confirmation (2 cases). No fetal loss has occurred. All samples were cultured successfully. Fourteen cases (8.38%) have been found with an abnormal karyotype. Four mosaic trisomic cases (2 mosaic trisomy 16, 1 mosaic trisomy 20, and 1 mosaic trisomy 8) were verified to be normal.</p><p><b>CONCLUSION</b>Repeated invasive prenatal diagnosis does not increase the rate of fetal loss. It can be recommended to cases with failed amniocyte culture. Caution should be undertaken when counseling prenatally detected mosaicism trisomies.</p>
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Adult , Female , Humans , Middle Aged , Pregnancy , Young Adult , Amniocentesis , Fetal Diseases , Diagnosis , Genetics , Karyotyping , Methods , Prenatal Diagnosis , Methods , TrisomyABSTRACT
Colorectal polyps are common digestive system diseases in children. The important role of endoscopy in the di-agnosis and treatment of colorectal polyps in children has been recognized. With the continuous development of endoscopic techniques, the diagnosis and treatment of colorectal polyp has become safer, more convenient and more effective. In this re-view, the progress in endoscopy for diagnosis and treatment of colorectal polyps in children has been summarized.
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Objective To investigate the clinical significance of narrow-band imaging (NBI) system in the diagnosis and treatment of Peutz-Jeghers syndrome (PJS) in children. Methods To retrospectively summarize the clinical data of 15 cases diagnosed with PJS, and compare with 70 cases diagnosed with juvenile polyp. And all of the polyps were further diagnosed with pathological examination and the histological type should be analyzed.The polyps of 15 children with PJS were diagnosed with the white light imaging (WLI) and the NBI system, respectively. The pit patterns of various polyps was observed with NBI. We made a comparison between the sensitivity and speciifcity of NBI and WLI in diagnosis of adenomatous polyps. Result 76 lesions in 15 cases were detected by the WLI and NBI system,including adenomatous polyps (12) and harmatoma (64) which were further diagnosed by pathological examinations.By using the NBI system,69.7% (53/76)PJS polyps (pit patterns)were diagnosed as typeⅠand 27.6%(21/76) PJS polyps were diagnosed as typeⅡorⅢ.By using the NBI system,the sensitivity and speciifcity for diagnosing PJS polyps were 83.3%(10/12)and 98.4%(63/64),which were obviously higher than those by using the WLI system (P<0.05). Conclusion Observation of pit patterns of polyps by the NBI system can help predict the pathological changes of PJS polyps.By using the NBI system,the sensitivity and speciifcity of the diagnosis of adenomatous polyps are higher than those by using the WLI system.It has guiding signiifcance to choose the method to remove a polyp.
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Objective To explore the clinicopathologic features,diagnostic criteria and clinical prognostic factors of Goblet cell carcinoid (GCC) of the appendix.Methods The clinical and pathological data from 6 GCC patients were analyzed including age,clinical stage,surgical procedure,outcome,macroscopic features,histological sections and immunohistochemistry.Results The median age was 49.67 years old.Clinically,4 patients presented the signs and symptoms of acute appendicitis,while 2 patients presented the signs and symptoms of abdominal pain.4 patients of them undergone the simple appendectomy,the other 2 undergone the right hemicolectomy.All patients who had undergone the operation treatment survived.One patient was lost to the follow-up.Macroscopically,no masses were found in the appendix.Microscopically,4 cases showed that the tumor cells were identical to the goblet cell normal small intestinal crypts morphologically.The atypia,necrosis and mitotic figures of neoplasm cells were absent.2 cases were composed of small,discrete acini,tubules lined by a single layer of cuboidal or columnar cell,the signet-ring cells were uniform with pattern of infiltration being nests,rosrttes,or clumps without a dintinct lumen.All GCC cases were positive to Syn,4 cases were positive to CgA,some cases expressed NSE,CD56,CK7,CK20,Ki-67 index of 5 cases was under 2 ％,the other 1 was 3 ％.None had lymph node metastases,intestinal metastases or ovary metastases.Conclusions GCC of appendix is a rare neoplasm,and has more aggressive behaviour than classic carcinoids.Positive expression of Syn and CgA is necessory for the diagnosis of GCC,Ki-67 index may suggest the grading of tumor.