Treatment of Bone and Joint Diseases with Gancao Fuzitang： A Review / 中国实验方剂学杂志

Gancao Fuzitang originates from the Treatise on Febrile Diseases and Miscellaneous Diseases （《伤寒杂病论》） and is mainly used to treat pain in the bones and joints and symptoms such as no flexion or extension. It has the effect of tonifying the spleen and kidney and removing dampness and turbidity， so it is widely used in the clinical treatment of various bone and joint diseases. This article reviewed the clinical research and mechanism of Gancao Fuzitang in the treatment of bone and joint diseases. The research has found that this prescription has good efficacy in treating bone and joint diseases such as rheumatoid arthritis， rheumatoid arthritis， ankylosing spondylitis， gout， and intervertebral disc herniation. Its mechanism of action may be related to regulating the level of inflammatory factors， antioxidation， and the protein expression of inflammatory and apoptotic cell-related pathways， improving bone and joint diseases， and alleviating related symptoms. This study can provide a reference for further deepening the research on the prevention and treatment of bone and joint diseases with Gancao Fuzitang.

Effects of pranlinide on cognitive behavior, β amyloid protein 6E10, inflammatory factors and neuronal cell morphology in brain and retina of 5×FAD mice and WT mice / 解剖学报

[Abstract] Objective To study the effects of pranlinide on cognitive behavior, β amyloid(Aβ) protein 6E10, inflammatory factors and neuronal cell morphology in brain and retina of 5×FAD mice and WT mice. Methods Thirty two 5×FAD mice and 16 WT mice were selected. All were female. 5×FAD mice were randomly divided into blank group and treatment group; No treatment was given in WT group. Blank group was intraperitoneally injected with PBS; treatment group was received intraperitoneal injection of pranlinide once a day for 8 weeks. The changes of cognitive ability were measured by Morris water maze test. The expression of Aβ6E10 protein in mice hippocampal cells and retina was detected by immunohistochemistry. Tumor necrosis factor α(NF-α) was determined by enzyme-linked immunosorbent assay. The same method was also used for interleukin-1β(IL-1β) detection (The content of inflammatory factors). The arrangement and morphology of nerve cells in mouse hippocampal tissue were determined by hematoxylin-eosin (HE) staining. Results The latency time of treatment group was shorter than that of 5×FAD group,and the times of crossing the platform and the percentage of target quadrant stay in the treatment group were higher than those in the 5×FAD group, and the differences were statistically significant (P0. 05). Compared with the 5×FAD group, the nerve cells in the treatment group were arramged in order and clear relatively. The distribution of glial cells was concentrated; The surrounding clearance was small. Conclusion Pranlinide can improve the cognitive ability of mice. The arrangement of nerve cells is regular, the shape is regular and the boundary is clear; The distribution of glial cells is concentrated; surrounding of clearance decrease. Aβ6E10 is synchronized in brain and retina.

Delayed interval delivery after cervical cerclage in twin pregnancies: report of four cases / 中华围产医学杂志

We report the management and maternal and neonatal outcomes of four cases of delayed interval delivery after cervical cerclage in twin pregnancies, who hospitalized in Shanghai First Maternity and Infant Hospital from year 2017 to 2018. Four patients with dichorionic diamniotic twin pregnancies all presented with gradually weakened uterine contractions after spontaneous vaginal delivery of twin 1. After informed consent, the patients received cervical cerclage at 2 to 3 days after delivery when the maternal and fetal conditions were stable, to delay delivery of twin 2. The gestational weeks at delivery of twin 1 were 25 +4, 23 +1, 27 +1, and 23 weeks, which were noted for 30 +1, 32 +6, 31 +4, and 24 weeks for twin 2, respectively. Delayed delivery intervals were 32, 69, 31 and 7 d. Three of the four twin 2 survived, with Apgar score ≥ 8 at 1 minute and birth weight of 1 390, 2 290 and 1 620 g. During a 2-year follow-up, no developmental abnormalities were observed in the children, and no serious maternal complications were found, including severe infection, bleeding or cervical laceration.

Down-regulated miR-149-5p contributes to preeclampsia via modulating endoglin expression.

OBJECTIVE: Endoglin is expressed in human placenta and plays an important role in the pathogenesis of preeclampsia. Dysregulation of microRNAs in placental tissues has been recently suggested to be involved in the pathogenesis of preeclampsia. Until now, few studies have shed light on the correlation between endoglin and microRNAs, the latter of which may regulate the expression of ENG, a gene encoding endoglin, in placenta. In this study, we aim to investigate the regulation of ENG by microRNAs. STUDY DESIGN: We located the microRNAs that might regulate the expression of ENG. Candidate microRNAs were tested if they had an impact on trophoblast function. MAIN OUTCOME MEASURES: We compared endoglin expression between normotensive and preeclamptic placentas by using immunohistochemistry and real-time PCR. Downregulated microRNAs in preeclamptic placenta were revealed from a literature review. A bioinformatics assay was performed to predict those that might target ENG. Real-time PCR, Western blotting and dual luciferase assay were used to verify the targeting. The effects of the microRNAs on trophoblasts were evaluated by transwell invasion assay. RESULTS: The endoglin level was significantly higher in preeclamptic placenta than in normotensive placenta. ENG was validated as the direct target of miR-149-5p and was inversely correlated with it. MiR-149-5p promoted the invasion of trophoblast cells, and this promotion was abrogated by the overexpression of ENG. CONCLUSIONS: Our findings highlight the importance of miR-149-5p in the pathogenesis of preeclampsia and provide new insight into the development of the disease.

Clinicopathological Analysis of Children's Systemic EBV-Positive T-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore the clinical and pathologic features as well as prognosis of systemic EBV-positive T-cell lymphoma in children.@*METHODS@#The clinical data including clinical manifestation, pathologic changes and treatment in 16 patients with children's systemic EBV-positive T-cell lymphoma were analyzed retrospectively, and follow-up of patients were carried out.@*RESULTS@#The 16 cases included 12 males and 4  females with median age of 3.3 years old. It was demonstrated that the clinical and pathological features of the children's systemic EBV-positive T-cell lymphoma were as followed fever, hepatosplenomegaly, cytopenia, lymphadenopathy, and hemophagocytosis in bone marrow or organ. Histologically, the structures of lymph node was normal, partially or completely destoryed. The paracortical zone was expanded with prominent infiltration of small to medium-sized atypical lymphocytes. The major immunophenotypic characteristics were as follows: (1) Almost all biopsies exhibited prominent T cell proliferation. (2) CD3 was expressed in 16 patients (100%, 16/16), CD4 in 5 patients (31.3%, 5/16)，CD5 in 13 patients (81.3%, 13/16)，CD7 was expressed in 11 patients (68.8%, 11/16)，CD8 in 15 patients (93.8%, 15/16)，CD4 and CD8 were expressed in 5 patients (31.3%, 5/16)，CD4 and CD8 double-negative in patients (6.3%, 1/16)，16 patients were CD56 negative (100%, 16/16). (3) TCR gene cloning rearrangement in 16 patients (93.8%, 15/16). (4) EBV-EBER was expressed in 16 patients (100%, 16/16). 11 out of 16 cases died, 1 cese failed to be followed up, 1 case relapsed，and 3 cases survived, reseptively. The media survival time was 4 months.@*CONCLUSION@#Systemic EBV-positive T-cell lymphoma predominantly occurred in childhood and early teen-age, and lacks specific clinic features, usually combined with hemophagocytic syndrome. The confirmed diagnosis requires comprehensive analysis of clinical manifestation, pathomorphology, immunohistochemical detection, EBV-EBER insite hybridization, and TCR gene test. The overall prognosis of the disease is poor and the fatality rate is high.

Risk management of postpartum hemorrhage / 中国实用妇科与产科杂志

Postpartum hemorrhage,a frequent emergency in obstetrics,is the first reason for maternal mortality in China and worldwide.The contributors to adverse outcome included delayed treatment because of underestimation of blood loss,lack of blood products,lack of treatment algorithms,lack of knowledge and training,insufficient interdisciplinary communication and inadequate management.Therefore,it is essential to improve the management of medical institutions and set up a protocol for emergency situations.Meanwhile,the key point in rescue postpartum hemorrhage is the teamwork with efficient training and cooperation.This article made a review on the management of postparttum hemorrhage,establishment of emergengy protocol and risk assessment and team cooperation based on guidelines and recommendations published by main authorities and the latest studies.The goal of the article is to provide some ideas to reduce the frequency of severe hemorrhages after delivery and improve maternal outcomes.

Assessment of fetal reserve in the perinatal period / 中国实用妇科与产科杂志

It is crucial to assess the fetal reserve function and intrauterine health status before and during labor,based on antenatal high risk factors and fetal surveillance methods such as intrapartum electronic fetal monitoring and fetal scalp stimulation,which can guide clinicians to intervene in a timely and effective manner,thus avoiding adverse outcomes due to fetal hypoxia.

Risk factors for fetal death after radiofrequency ablation for complicated monochorionic twin pregnancies.

OBJECTIVE: Radiofrequency ablation (RFA) is a management alternative for complicated monochorionic twin pregnancies. The purpose of this study is to evaluate risk factors for fetal death after RFA. METHODS: An observational study was performed to document the perinatal outcomes of all cases undergoing fetal reduction using RFA from 2010 to 2016 at the Shanghai First Maternity and Infant Hospital. A multiple regression model was built to identify predictors of the death of the remaining fetus after RFA. RESULTS: A total of 183 patients treated with RFA for fetal reduction were analyzed, including 53 selective intrauterine growth restriction, 35 twin-twin transfusion syndrome, 36 dichorionic triamniotic triplets, 24 monochorionic twins discordant for fetal anomaly, and 35 twin reversed arterial perfusion. The prevalence of fetal death after RFA was 23% (43:183). The occurrence of fetal death after RFA was independently associated with more than 2 cycles of RFA coagulation (OR 3.46; 95% CI, 1.34-8.94; P = .01). CONCLUSION: More than 2 cycles of RFA coagulation is the only independent risk factors of fetal death after RFA.

March of the partogram / 中华围产医学杂志

In 1930s, Wolf created the first partogram. In 1950s, Friedman proposed the classical model of partogram that has been applied in clinical labor assessment ever since. Over the past ten years, Zhang has made great improvement in this field. Here, we reviewed the three different stages in partogram research (the first proposed stage, Friedman's classical stage and Zhang's stage) in terms of its background, demographic characteristics and clinical application. Moreover, this article also emphasized the necessity of partogram research and discussed the prospects for future research and clinical application based on the recent progress in China.

ReaI-time positioning of the abIation catheter uItrasonic probe in the heart:a simuIation experiment / 中国组织工程研究

BACKGROUND: Three-dimensional magnetic field positioning and three-dimensional electric field positioning are two main technologies used in heart ablation, but their required equipments are very expensive. OBJECTIVE: To develop a new method of ablation catheter positioning by combining ultrasonic probe with ablation catheter. METHODS: Three-dimensional data of human heart were obtained from the anatomical data set of the body, and then a three-dimensional vector model of the endocardial surface was established. The basic parameters and scanning strategy of ultrasonic probe were designed and calculated, to compile a corresponding simulation software. Based on the three-dimensional endocardial vector model, the detection data of the ultrasonic probe were obtained by simulation calculation and processed. Then, the target surface characteristics were reconstructed, matching with the surface features of the proposed vector model. The position of the probe was finally determined. RESULTS AND CONCLUSION: The three-dimensional model of the endocardium was established based on the anatomical data set, and the ultrasonic surface detection data were obtained by the simulated ultrasonic irradiation. The reconstructed surface model with high accuracy exhibited a desired match with the target area in the three-dimensional model of endocardium. The error of the probe position and its theoretical position fulfilled the requirement of positioning accuracy. In conclusion, the use of ultrasonic imaging technology can accurately position the catheter probe in the heart during heart ablation, providing an accurate and reliable navigation for the implementation of heart ablation.

Highly Efficient Carbon Monoxide Capture by Carbanion-Functionalized Ionic Liquids through C-Site Interactions.

A novel method for the highly efficient and reversible capture of CO in carbanion-functionalized ionic liquids (ILs) by a C-site interaction is reported. Because of its supernucleophilicity, the carbanion in ILs could absorb CO efficiently. As a result, a relatively high absorption capacity for CO (up to 0.046 mol mol-1 ) was achieved under ambient conditions, compared with CO solubility in a commonly used IL [Bmim][Tf2 N] (2×10-3  mol mol-1 ). The results of quantum mechanical calculations and spectroscopic investigation confirmed that the chemical interaction between the C-site in the carbanion and CO resulted in the superior CO absorption capacities. Furthermore, the subsequent conversion of captured CO into valuable chemicals with good reactivity was also realized through the alkoxycarbonylation reaction under mild conditions. Highly efficient CO absorption by carbanion-functionalized ILs provides a new way of separating and converting CO.

Related factors of cesarean section and predictive validity based on Robson Ten-Group Classification System / 中华围产医学杂志

Objective To explore the relationship between the obstetric factors defined by Robson Ten-Group Classification System (RTGCS) and cesarean section rate (CSR),and to evaluate the validity of predictive models established based on the RTGCS for cesarean section.Methods Clinical data of 41 295 cases delivered in Shanghai First Maternity and Infant Hospital from January 1,2012 to September 30,2014 were retrospectively collected.CSR of different groups categorized by the RTGCS was analyzed by descriptive epidemiological methods by three models.Model 1 was obstetrics factors (parity,history of cesarean section,number of fetus,mode of labor,fetal presentation and gestational age);model 2 was obstetrics factors (model 1) + demographic characteristics and severity (maternal age and with/without treatment in intensive care unit);model 3 was defined as model 2+ complications (placenta previa,placental abruption,chronic or gestational hypertension,preeclampsia,renal disease,or human immunodeficiency virus infection).The relationship between obstetrics factors classified by the RTGCS and CSR was analyzed by the logistic regression model (the potential confounders were controlled).The validity of predictive models was evaluated by analyzing the area under the receiver operative characteristic (ROC) curve.Results (1) There were statistical differences in total CSR and CSR before labor among those cases respectively grouped by age,medical insurance,parity,signal/multiple pregnancy,fetal presentation and gestational age (all P＜0.05).(2) The recruited cases were categorized into ten groups according to the RTGCS and among them,the second group (single,cephalic presentation,nulliparous,≥ 37 gestational weeks,induced labor or cesarean section before labor) accounted for most of the cesarean section cases (61.2％,11 217/18 322),followed by the fourth group (single,cephalic presentation,multiparous,no previous cesarean section,≥ 37 gestational weeks,induced labor or cesarean section before labor),which were 11.2％ (2 061/18 322).(3) Obstetrical parameters,including parity,number of fetus,mode of delivery,history of cesarean section,fetal presentation and gestational weeks at delivery were related to CSR,even after adjustment for maternal age and medical insurance,or obstetrical complications,or both above factors (all P＜0.05).(4) Areas under the ROC curves and the 95％ confidence intervals of model 1,2 and 3 were 0.867 (0.863-0.870),0.875 (0.872-0.878) and 0.881 (0.878-0.885),respectively (all P＜0.01).Conclusion Related variables of RTGCS highly correlate with CSR and could be used as promising indicators for prediction of cesarean section.The RTGCS is of great application value to those research subjects.

Effect of Pirin on the proliferation and self-renew of glioma stem cell / 国际药学研究杂志

Objective To study the effect of Pirin(an iron-binding nuclear protein)on the proliferation and self-renewal of glioma stem cell(GSC)so as to provide a potential therapy target for malignant glioma.Methods PLKO.1-shPirin lentiviral plasmids were constructed to stably knock down Pirin in GSC by using lentivirus infection system.The interference efficiency of Pirin short hair?pin RNA(shRNA)was detected by Western blotting. The capacity of GSC was examined by the assessment of cell viability. Tumor sphere formation assay was used to detect the effect of Pirin on GSC self-renewal capacity. Results Pirin was highly expressed in GSC.Consistently,the protein level of Pirin in the conditioned medium from GSC was much higher than that from the corresponding non-stem tumor cell(NSTC).Gene-sequencing analysis demonstrated that PLKO.1-shPirin lentiviral plasmids were successfully con?structed.Pirin shRNA transfection significantly inhibited the expression of Pirin in GSC and suppressed the cell viability and ability of tumorsphere formation.Conclusion Knocking down Pirin significantly inhibites the cell proliferation and self-renewal of GSC.

Multi-Molar Absorption of CO2 by the Activation of Carboxylate Groups in Amino Acid Ionic Liquids.

A new strategy for multi-molar absorption of CO2 is reported based on activating a carboxylate group in amino acid ionic liquids. It was illustrated that introducing an electron-withdrawing site to amino acid anions could reduce the negative inductive effect of the amino group while simultaneously activating the carboxylate group to interact with CO2 very efficiently. An extremely high absorption capacity of CO2 (up to 1.69 mol mol(-1) ) in aminopolycarboxylate-based amino acid ionic liquids was thus achieved. The evidence of spectroscopic investigations and quantum-chemical calculations confirmed the interactions between two kinds of sites in the anion and CO2 that resulted in superior CO2 capacities.

Rational design and synthesis of a porous, task-specific polycarbazole for efficient CO2 capture.

We present a rational design and synthesis of a novel porous pyridine-functionalized polycarbazole for efficient CO2 capture based on the density functional theory calculations. The task-specific polymer, generated through a one-step FeCl3-catalyzed oxidative coupling reaction, exhibits a superior CO2 uptake at 1.0 bar and 273 K (5.57 mmol g(-1)).

Perinatal outcomes following selective feticide by radiofrequency ablation in complex monochorionic ;pregnancies / 中华围产医学杂志

To assess the perinatal outcomes following selective feticide through radiofrequency ablation (RFA) in complex monochorionic pregnancies. Methods In this retrospective observational study, 34 cases of complex monochorionic pregnancies treated with RFA for selective feticide and delivered at the Shanghai First Maternity and Infant Hospital between January 1, 2012 and December 31, 2013, were included. Gestational age at RFA, the number of RFA cycles, maternal and fetal complications, gestational age at delivery, neonatal outcomes at 28 days after birth and neonatal development after birth were recorded. Fetal survival rate were defined as the number of survivors at 28 days after birth divided by the number of remaining fetuses after RFA. Factors affecting fetal survival rate were also analyzed. Statistical analysis was performed using Fisher's exact test. Results (1) The process for RFA:The gestatinal age for the procedure was (20.7±3.1) weeks(16+1-27+6 weeks). The successful rate of procedures was 100%(34/34) and the cycle number for RFA was 1-6 times. (2)Fetal complications and survival rate of remaining fetuses after RFA:there were six pregnant women suffering from premature rupture of membrane (PROM) before 28 weeks. Among those women, one had miscarriaged at 25 weeks, one chose to terminate at 26 weeks and the remaining four chose to continue the pregnancy. There were three remaining fetuses developing fetal severe anemia with hydrops after RFA. Two of them had fetal demises 2 days after the procedures and one chose to have termination. Another two cases with discordant fetal anomalies had fetal demises with unknown reasons one day after RFA. There were 27 remaining fetuses after RFA who survived until 28 days after birth. The mean gestational age at delivery was(36.4±4.1)weeks (26+4-40 weeks) and the mean birth weight was (2 913± 978) g (1 080-4 600 g). The overall fetal survival rate 28 days after birth was 79%(27/34). There were no abnormal findings in antenatal magnetic resonance imaging (MRI) four weeks after the procedure and no abnormal development of nervous system in the surviving neonates between 3 months old and 1.5 years old. (3) Factors affecting fetal survival rate :There were no significant differences identified in the rate of fetal severe anemia and fetal demise (2/15, 2/13 and 1/6), the rate of PROM before 28 weeks (1/15, 4/13 and 1/6) and survival rate of 28 days after birth (13/15, 10/13 and 4/6)among three groups with different gestational age (16+1-, 20- and 24-27+6 weeks) for RFA(all P>0.05). The indications for RFA included severe selective intrauterine growth restriction (50%, 17/34), discordant for fetal abnormalities(24%, 8/34) , twin reversed arterial perfusion sequence(18%, 6/34)and dichorionic or monochorionic triamniotic pregnancy (9%, 3/34). There were also no significant differences noted in the rate of fetal complications and fetal demise(3/17, 2/8, 0/6, 0/3), the rate of PROM before 28 weeks (3/17, 0/8, 2/6, 1/3)and survival rate of 28 days after birth among different groups (12/17, 6/8, 6/6, 3/3) with different indications for RFA(all P>0.05) . No significant differences observed in the rate of fetal complications and fetal demise(10% and 2/5)and the rate of PROM before 28 weeks (17%and 2/5)between two groups with different cycle numbers for RFA (<3 times and≥3 times, all P<0.05), while the group with cycle number ≥ 3 times had lower survival rate 28 days after birth than the group with cycle number<3 times for RFA (2/5 vs 86%, P<0.05). Conclusions RFA is one of effective and safe procedures for selective feticide in complex monochorionic pregnancies.

Overexpression of the dominant-negative form of interferon regulatory factor 1 in oligodendrocytes protects against experimental autoimmune encephalomyelitis.

Interferon regulatory factor 1 (IRF-1) is a transcription factor that has been implicated in the pathogenesis of the human autoimmune demyelinating disease multiple sclerosis (MS) and in its animal model, experimental autoimmune encephalomyelitis (EAE). The goal of the present study was to directly examine the role of IRF-1 in oligodendrocyte injury and inflammatory demyelination. For the purpose of this study, we generated a transgenic mouse line (CNP/dnIRF-1) that overexpresses the dominant-negative form of IRF-1 (dnIRF1) specifically in oligodendrocytes. CNP/dnIRF-1 mice exhibited no phenotypic abnormalities but displayed suppressed IRF-1 signaling in oligodendrocytes. The major finding of our study was that the CNP/dnIRF-1 mice, compared with the wild-type mice, were protected against EAE, a phenomenon associated with significant reduction of inflammatory demyelination and with oligodendrocyte and axonal preservation. The observed protection was related to suppressed IRF-1 signaling and impaired expression of immune and proapoptotic genes in oligodendrocytes. No significant differences in the peripheral immune responses between the wild-type and the CNP/dnIRF-1 mice were identified throughout the experiments. This study indicates that IRF-1 plays a critical role in the pathogenesis of EAE by mediating oligodendrocyte response to inflammation and injury. It also suggests that oligodendrocytes are actively involved in the neuroimmune network, and that exploring oligodendrocyte-related pathogenic mechanisms, in addition to the conventional immune-based ones, may have important therapeutic implications in MS.

Central nervous system expression of interferon regulatory factor 1 regulates experimental autoimmune encephalomyelitis.

Interferon regulatory factor 1 (IRF-1) is a transcription factor that has been implicated in the disease mechanisms of experimental autoimmune encephalomyelitis (EAE). In this study, we examined the role of central nervous system (CNS) expression of IRF-1 in the natural course of EAE. In an effort to dissect the CNS effects from the peripheral immune effects of IRF-1, we generated bone marrow chimera mice that differentially expressed IRF-1 in the CNS and in the immune system. We found that mice lacking IRF-1 in the CNS developed significantly milder clinical symptoms and shorter disease duration compared to those with wild-type background. Based on these results, we concluded that the CNS expression of IRF-1 regulates the disease process in EAE. Our findings are relevant to the inflammatory mechanisms involved in multiple sclerosis and may provide a basis for development of novel therapeutic targets of the disease.

STAT1/IRF-1 signaling pathway mediates the injurious effect of interferon-gamma on oligodendrocyte progenitor cells.

Interferon-gamma (IFN-gamma) is a pleiotropic cytokine that is critically involved in the pathogenesis of inflammatory demyelinating diseases. There is strong evidence that IFN-gamma can function as a distinct and independent injurious factor to oligodendrocyte progenitor cells (OPCs). The intracellular signaling pathways leading to OPC death, however, remain poorly understood. In this study, we examined IFN-gamma signaling in OPCs in relation to cell death in vitro. Using expression knock-down and forced overexpression methods, we directly demonstrated the role of signal transducer and transcription activator 1 (STAT1) and interferon-regulated factor 1 (IRF-1) in IFN-gamma- induced OPC death. In addition, our study identified two proapoptotic genes, caspase 1 and double-stranded RNA-dependent protein kinase (PKR), whose expression was upregulated by IFN-gamma and transcriptionally controlled by IRF-1. The conclusion of this study is that STAT1 and IRF-1 function as components of the signaling pathway that mediates IFN-gamma-induced OPC death.

Clinical study on dinoprostone suppositories 0.8 mm used in cervical ripening and labor induction of women with term pregnancy of premature rupture of the membranes:a multicenter study / 中华妇产科杂志

Objective To investigate safety and efficacy of dinoprostone suppositories(0.8 mm) used in cervical ripening and labor induction in women with term premature rupture of the membranes.Methods One hundred women of term monocyesis with premature rupture of the membranes,head presentation,bishop score less than 6(test group)and 180 women with intact fetal membranes(control group)were enrolled into this multicenter,prospective clinical study.The vaginal delivery system was inserted into the posterior foruix,and the patients were recumbent for 2 hours after insertion.The interval time from using dinoprostone suppositories to uterine contraction,to labor and delivery were recorded.The following index were also recorded and compared,including the mean inserted time of dinoprostone suppositories,fetal heart beat,meconium stained amniotic fluid,hyperstimulation of uterus and the other complications,mode of delivery,stage of labor,postpartum hemorrhage,status of neonates.Results Three cases intest group and 23 casesin control group weren't in labor within 24 hours.The rate of labor within 24 hours in test group was significant higher than that in control group(97.0% vs.87.2%,P<0.01).It was observed that 73 cases undergoing vaginal deliveries(75.3%,73/97)and 24 cases undergoing cesarean section dehveries(24.7%,24/97)in test group and 107 cases undergoing vaginal delivery(68.2%,107/157)and 50 cases undergoing cesarean section delivery(31.8%,50/157)in control group,when compared the rate of vaginal or cesarean section deliveries between two group,it didn't reach statistical difference (P >0. 05). It had no significant difference in the interval time from using dinoprostone suppositories to labor starting and the mean inserted time and the total labor time between two groups ( P > 0.05 ). The incidence of uterine tachysystole was 11.3% (11/97) in test group and 19. 1% (30/157) in control group (P>0. 05), which did not reach statistical difference (P>0. 05). There wasn't neonatal asphyxia in both groups. Conclusion It was safe and efficient to use dinoprostone suppositories for cervical ripening and induction of term pregnancy with premature rupture of the membranes, however, monitoring should be intensified.