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<p><b>OBJECTIVE</b>To explore the clinical value of screening the serum markers during the second trimester of pregnancy in preventing congenital birth defect and predicting the pregnancy outcome.</p><p><b>METHODS</b>Between November, 2011 and October, 2013, a total of 25 520 pregnant women (15-20+6 gestational weeks) underwent a screening test of triple serum markers including free beta-human chorionic gonadotrophin (free βhCG), alpha-fetoprotein (AFP), and unconjugated estriol (µE3) during the second semester of pregnancy. The women identified by the screening test as having high risks were referred to invasive prenatal diagnosis by amniocentesis, or to color Doppler ultrasound examination for suspected patent neural tube defect (NTD), and their pregnancy outcomes were followed up.</p><p><b>RESULTS</b>High-risk pregnancies were identified by the screening test in 4.91% (1254/25520) of the total cohort. Of the 818 patients receiving invasive prenatal diagnosis, the abnormal rate was 5.75% (47/818). The high-risk pregnancies identified by the screening test was associated with a significantly higher rate of abnormal outcomes compared with the low-risk pregnancies (1.91% vs 0.1%, P<0.01). Of the 210 high-risk cases of NTD, a definite diagnosis was established in 34 cases. We also found that pregnancies at an advanced age (>35 years) was associated with increased risks for trisomy 21 compared with those at younger ages (15% vs 1.65%P<0.01). The detection rate of abnormal karyotypes in pregnancies with an abnormal MoM value of a single marker was 3.17% (6/189).</p><p><b>CONCLUSION</b>Screening tests of serum markers during the second trimester of pregnancy can be helpful to identify fetal chromosomal and anatomical anomalies, predict unfavorable pregnancy outcomes, and prevent birth defects in pregnancies at an advanced age. The MoM value of a single marker in the second trimester can be indicative of potential chromosomal abnormalities.</p>
Subject(s)
Female , Humans , Pregnancy , Biomarkers , Blood , Chorionic Gonadotropin, beta Subunit, Human , Blood , Chromosome Aberrations , Down Syndrome , Diagnosis , Estriol , Blood , Neural Tube Defects , Diagnosis , Pregnancy Outcome , Pregnancy Trimester, Second , Blood , Prenatal Diagnosis , alpha-FetoproteinsABSTRACT
The aim of this experiment was to construct a human colorectal carcinoma cDNA phage expression library. Total RNA was extracted from the cancer tissue of human colorectal carcinoma, and the mRNA was purified. The single-strand and double-strand of cDNA were synthesized through reverse transcription-PCR and LD-PCR. cDNA fragments, after removal of those smaller than 500bp, were combined with ?TriplEx2 phage vector. The recombinant cDNA were packaged in vitro with MaxPlax TM Packaging Extract, then a small portion of packaged phage was used to infect E.coli XL1-blue for titration and determination of the percentage of recombinant clones. PCR method was used to identify the size of inserted cDNA. A human colorectal carcinoma cDNA phage library consisting of 2.07?10 6 pfu/ml recombinant bacteriophages was successfully constructed, the recombinant percentage was 94.5%, and the range of the fragment length of exogenous inserted cDNA was between 600bp～4kb, with an average of about 1.4kb. It met the universally accepted standards, and it could be useful in screening cDNA clones to find out the human colorectal carcinoma associated antigen genes.
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Objective To evaluate the curative effect of valsartan associated with low-dose amiodarone on the recurrence of atrial fibrillation (AF), the left atrial diameter (LAD), P wave dispersion (Pd) and the maximum P wave duration (Pmax) in patients with paroxysmal AF. Methods 76 patients with paroxysmal atrial fibrillation (PAF) were randomized to valsartan (test group) and placebo (placebo group), both associated with low-dose amiodarone, and were followed up for 18 months. The patients were asked to report any episode of symptomatic atrial fibrillation and to perform an ECG as early as possible. AF load, Pmax, Pd and LAD were measured before and at the 6th, 12th, and 18th month after the treatment. Results At least one ECG-documented episode of AF was reported in 16% of the patients in test group and in 41% in placebo group, the difference was significant (P
ABSTRACT
The human venous valve of the brachial,femoral and long saphenous veins wereexamined with light,transmission and scanning electron microscopy.The observationshows that the venous valve is composed of three functional layers covered withendothelium on both surfaces.A loosely structured layer is located underlying theendothelium.A network mainly containing randomly oriented elastic fibers was foundnear the side towards the lumen.To the side towards the venous wall,there is adense layer composed of eircumferentially and transversly oriented collagen bundles.Some smooth muscle cells extend from the wall of the vein to the base of thevenous valve.The elastic fibers and smooth muscle cells together with the collagenfibers contribute to the mechanical load-bearing performance of the valve and to thepassive closing and openning mechanism.In addition,the smooth muscle cells mightplay an active role in the normal functioning of the valve.The scanning and transmission electron microscopy of venous valve showdifferent arrangement of the endothelium.On the surface of the valve next to the wallof the vein,the endothelial cells are transversely arranged,while on the othersurface over which the current of blood flows,the cells are longitudinally arrangedin the direction of the current.These accord with the role of fluid mechanics.12 normal venous valves were tested by universal testing instrument (Instrontype 1122).The mean value of the maximum tension of the valve is 1 N.Theaverage value of the tensile ultimate strength is 10N/mm~2.
ABSTRACT
The contents of dopamine (DA) and its metabolites, homovanillic acid (HVA) and 3,4-dihydroxyphenyl acetic acid(DOPAC), in both striata were determined with HPLC-EC technique in each of 28 albino rats, which were divided into 3 groups (bilateral lesioned, unilateral lesioned and healthy control groups). Among the unilateral lesioned rats, three indices such as DA, HVA/DA and DOPAC/DA in the lesioned striata were 22.27％, 420.00％ and 199.75％ of those of the intact striata, respectively. This suggests that there may be an enhanced compensatory DA release in the striatum ipsilateral to the lesion of the rat. Having compared the lesioned striata of unilateral lesioned rats with those of bilateral lesioned animals, and the intact striata of unilateral lesioned rats with those of the control ones, we did not find any significant differences in DA, HVA/DA or DOPAC/DA. The result implies that the compensatory DA release in the lesioned striatum probably accounts for the mechanism of the ipsilateral nigrostriatal system, not for the crossed nigrostriatal fibers.
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The diameters and projection area of the articular surfaces, contributed to the formation of the sacroiliac joint, were determined on 50 sets of pelvic bones with image analysing apparatus.By drawing a line connecting the most anterior point of the prominence to the deepest point of the posterior incisure, the articular surface may be divided into a superior and an inferior portions. The inferior portion was larger than the superior portion. Each portion of the articular surface on the ilium is slightly larger than that on the sacrum.In order to explore the relationship between the form of the articular surface and its function in transmitting the gravity of the human body, the stress of the neighbouring area near the anterior margin of the articular surface was determined. Moreover, the bony architecture on the cross section passing through the articular surface was observed. It suggests that the strain in the neighbouring area was in linear equation with the gravity loaded on the spinal column. The strongest stress was determined at the anterior margin of the anterior prominence and the thickness of the cortex lying on the relevant bones appears most obvious at the same sites. These results further improve that the bony architecture was consistent with the strain in bearing the body weight. Besides, the form of the articular surface was also adapted to its function.
ABSTRACT
The projection area of the volar surface of the human hand was estimated on 52 young Chinese adults(26 males and 26 females.)ranging in age from 18 to 31. The average projection area of the volar surface of the hand was 145.20 square centimetres.It occupied 0.93％ of the calculated body surface.The area of the palm was 86.69 square centimetres, amounting to 59.70％ of the volar surface of the whole hand. All dimensions of different parts of the hand of males were larger than those of females. There was no difference between the right and left hands of both sexes. The coefficient of correlation among the body length, body weight, length and width of the hand, surface area of the whole body with the projection area of the volar surface of the hand was calculated. All showed close correlation. The regression of the estimation of the projection area of the volar surface of the hand with hand length and hand width was established. It is therefore to be assumed that the area of the volar surface of the hand calculated as one per cent of the body area, as it is often used in surgical examina- tions, seems to be a little higher than its real area(0.93％.
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This article is based on the observation of the temporomandibular joint(TMJ) and on the analysis of its morphological structure. The normal values of 15 items, used to represent the structure of the joint, have been established.Three indices, that is the glenoid fossa index, the articular tubercle index and the condyle index, are accepted to express the geometrical characters and to reflect the close relationship between the two functional parts of the joint. Besides, the frequency distributing curves are presented. It is concluded that the male's TMJ is eminently larger than the female's, while there is no distinct difference between left and right sides and between groups with or without occlusion. This result might meet the needs of the Clinical research as well as the design of the artificial TMJ.
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Some anatomical aspects in application for the vein catheterization on the subclavian and other veins of the neck have been studied on 85 cadavers in Chinese adults.The subclavian vein measures 1.16cm in diameter and 3.76 cm in length. It lies 2 cm deep under the skin and muscles in the infraclavicular region. The angle between the vein and the clavicle is 38?. It usually lies behind the medial third of the clavicle and is separated from the subclavian artery, brachial plexus and the cupula of the pleura by the anterior scalenus muscle. This muscle is 1.19 cm in width and 0.37 cm in thickness, much thinner than the thickness mentioned in the previous literature. The distance from the origin of the subclavian vein to the opening of the superior vena cava into the right atrium is 13.85 cm on the right, and 16.36 cm on the left.The diameter of the internal jugular vein and its topographical relationship to the origin of the sternocleidomastoid muscle were also observed. The internal jugular vein is 1.26 cm in diameter, and lies under the clavicular head of the sternocleidomastoid muscle in 58.75%, between the two heads of this muscle in 41.25%.The external jugular vein measures 0.63cm in diameter, but its location and termination are more variable.The application of these data in vein catheterization was also discussed in this article.
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The veins on the dorsum of the foot have been dissected and observed on 200cases of the Chinese adult lower extremities.The great saphenous vein is the chief draining vessel of the hallux,the toes andthe skin of the dorsum of the foot.The position and the tributaries of this vessel areconstant.Its diameter ranges from 1.9 to 5.0mm,with an average of 3.2mm.The dorsal venous arch is usually single(93%),double arches are seen in 6%,and absent in 1%.According to the form of reflux,the dorsal venous arch may begrouped into five types.In the most common type,the arch is continuous withthe great saphenous vein and the anterior malleolar branch of the small saphenousvein(49.5%).The dorsal metatarsal veins usually drain directly into the dorsal venous arch.Some of the neighboring dorsal metatarsal veins may drain through a commontrunk.The perforating veins on the dorsum of the foot may be divided into threedifferent groups:the anterior malleolar,marginal and intermetatarsal group.Thelatter usually drains into the dorsal venous arch at the base of the first intermeta-tarsal space.The valves of the superficial veins on the dorsum of the foot were also observed.There is no valve in the lateral part of the dorsal venous arch,but there may beone or two valves in its most medial part(66.7%).It appears that the venousblood from the first metatarsal vein usually drains into the great saphenous vein.
ABSTRACT
Popliteal fossa dissections were performed on two hundred adult extremities and the patterns of the deep venous system were observed. Three general types were established for the popliteal vein and its branches. Single large trunk representing the popliteal vein at the level of the knee joint occurs only in 32.00％, two venous trunks at this level in 65.50％ and three venous trunks in 2.50％. Furthermore, considerable variations of the formation of popliteal veins were found. The patterns of popliteal vein were divided into three main types and eleven subtypes. Type Ⅱa occurs most frequently (41.50％). The size of each vein of the deep venous system was measured. The average calibre of the single popliteal vein is 6.89mm (ranging between 4.0-11.5 mm). The veins from the gastrocnemius muscle join the single or the two popliteal trunks respectively. The veins of the soleus muscle drain into the peroneal and posterior tibial veins. The short saphenous vein typically terminates in the popliteal vein. Variations in its termination were described.
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The diaphyseal nutrient foramina were examined in 246 tibia and 212 fibula from complete sets of Chinese adult skeleton collection.The length and diameter of these bones were also measured.The number,position and orientation of the nutrient foramina were more variable in fibula than in tibia. Though the position of the nutrient foramina of the shaft of these bones were vari- able,however there was a restricted area in which most of the foramina were located. The nutrient foramina of the tibia usually situated on the posterior surface near the junction between the upper and middle thirds of its length,and that of the fibula was on the posterior or medial surface within the upper portion of the middle third segment. The nutrient artery to tibia and fibula were dissected and observed in 100 cases. The nutrient artery to tibia may have various sources of origin,it may arise from the posterior tibial,anterior tibial,and fibular arteries or directly from the popliteal artery. It has a larger calibre and runs over a longer course.The nutrient artery to fibula is relatively small and short,and all originate from the fibular artery. Certain practical applications of the arteries are briefly discussed.
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The structure of the articular cartilage and disc of the temporomandibular jointin rats and monkey were studied with light,transmission and scanning electronmicroscopy.The articular cartilage covering the mandibular condyle is semilunar in shapeon cross section.Its thickest portion lies posterosuperiorly.The bony trabeculaesubjacent to the cartilage arrange vertically to the articular surface and concentrateto the thickest portion of the articular cartilage.The articular cartilage covering the mandibular fossa is similar to that on themandibular condyle,but contains fewer cartilage cells.Lacking a calcified areawith enlarged cartilage cells,the articular cartilage here may only be divided intothree areas.The articular disc consists of three areas:an upper,a middle,and a lowerone.The structure and ultrastructure of different parts of these cartilages with theirfunctions have been discussed.
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The facial, retromandibular and external jugular veins of the neck were studied in a total of 230 Chinese cadavers.1. The external jugular vein can be divided into six types and fourteen subtypes. Type Ⅰ(40.22％) and type Ⅲ (29.13％) occurred more frequently in this series.2. The facial vein drains into the external jugular vein in 41.09％. It drains directly or indirectly into the internal jugular vein in 43.91％.3. The anterior branch of the retromandibular vein usually drains into the internal jugular vein and it runs through the space deep to the posterior, belly of the digastric and the stylohyoid muscles in 83.70％.4. The presence of the so called common facial vein occurred only in 29.13％.5. The external jugular vein often drains into the subclavian vein. It appears in 46.57％ in our observation.6. The external jugular vein crosses the inferior belly of the omohyoid muscle, when it runs downwards in the lower part of the external cervical triangle. It usually lies superficial to the omohyoid in 66.16％, deep to it in 26.35％.
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After removal of unilateral molars in the rats,the changes in the articularcartilage and articular disc of the temporomandibular joint and HRP uptake of thelining cells of synovial membrane were observed with light,transmission and scanningmicroscopy.The HRP uptake activity of the lining cells was lowered and degenerative chan-ges were presented in ths articular cartilages following the removal of the molars.It is suggested that the temporomandibular joint is intimately integrated with theocclusion of the upper and lower teeth.Defect of the teeth on one side mayinduce occlusion disorders.These will certainly cause some changes of the structureand function of the temporomandibular joint.
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Two-dimensional finite element stress analyses were employed to study the human mandible. Two models, three teeth loading conditions and three distributions of masticatory muscles are presented. Finite element analyses are compared with photoelastic experiments to indicate correspondence between both results. High stress concentrates in the mandibular angle, condylar region, retromolar area and dental orown.
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The diaphyseal nutrient foramina of 123 pairs of radius and 112 pairs of ulna from local Chinese adult skeleton collection have been observed. Their length, diameter and circumference were measured.The nutrient foramina on the shaft of radius, in longitudinal direction, located near the junction of the upper and middle thirds, and those of ulna located a little lower.In horizontal direction, the nutrient foramina chiefly concentrated on the anterior surface. But there were more foramina situated on the interosseous crest or posterior surface on radius than that on ulna.100 cases of nutrient artery to radius and ulna have been dissected on preserved cadavers. The length, diameter and distance from the origin of the artery to the level of elbow joint have been measured. The nutrient arteries to radius and ulna may have. various origins. They mostly arise from anterior interosseous, common interosseous, ulnar, ulnar recurrent and rarely from radial, median or dorsal interosseous arteries.The course and distribution of the nutrient arteries in the bone marrow cavity were examined on X-ray films prepared from injected radio-opaque specimens.
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The arteries of the foot in one hundred Chinese adult specimens were dissected and examined. 1. The dorsalis pedis artery was absent in 4%, and it originated from an abnormal origin in 5%, its course and relationship with the tendon of the extensor hallucis longus and deep peroneal nerve were also described. 2. The anterior medial and anterior lateral malleolar arteries originated more commonly at the level of the ankle joint, and sometimes they may originate from the dorsalis pedis artery. 3. The origin and number of the medial tarsal artery were variable, but that of the lateral tarsal artery were more constant. 4. The arcuate artery was present in 35%, but only 17% was typical in form, from which the 2nd-4th dorsal metatarsal arteries were giving off. 5. The sources of the dorsal metatarsal arteries were the most variable. The first dorsal metatarsal arteries which arose from dorsal or plantar aspect were similar in percentages. The 2nd-4th dorsal metatarsal arteries often originated from the plantar aspect, but it was not uncommon that they came equally from dorsal and plantar aspects. 6. The artery of the tarsal sinus was usually present, it may be divided into two categories, namely the proximal and the distal artery, with their distinct origins and courses. 7. The arterial trunks in the sole of the foot were more constant. The posterior tibial artery usually branched into its two main branches near the lower border of the laciniate ligament. 8. The lateral plantar artery was greater than the medial in 82%. And 71% of the plantar arch was formed chiefly by the deep plantar branch of the dorsalis pedis artery. 9. The plantar metatarsal arteries originated usually from the plantar arch, sometimes the neighbouring arteries may have a common trunk. The course of the Ist-3rd plantar metatarsal arteries was constant, but that of the 4th may be variable. Finally, some questions about the arteries of the foot, present in previous literatures, were briefly discussed.