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Objective To evaluate the value of non-invasive prenatal testing (NIPT) as first-trimester screen (FTS) for the detection of trisomies 21, 18 and 13. Methods This was a retrospective study. 8517 pregnancies who performed NIPT at Obstetrics and Gynecology Hospital of Fudan University from 2017 May to 2018 June. 14 cases (0.16％) were failed. 8503 pregnancies were divided into 2 groups:NIPT joint traditional screening, NIPT. High risk pregnancies were verified by prenatal diagnosis. Evaluate the performance of NIPT. All pregnancies were followed up. Frequencies were compared with Fisher′s exact test. Results 8517 pregnancies underwent NIPT. 14 cases (0.16％) were failed. 83 cases of remaining 8503 cases had high risk results, among which 29 were trisomy 21, 14 were trisomy 18, 6 were trisomy 13 and 34 were sex chromosome aneuploidies (SCA). In 2996 cases who underwent NIPT joint traditional screening, NIPT found 14 cases of common aneuploidies 12 cases of SCA. 11 and 3 cases were validated by invasive prenatal diagnosis, respectively. In 5507 NIPT cases, 35 cases of common aneuploidies and 22 cases of SCA were found, among which 29 and 11 cases were validated. There was no significant differences between two groups for common aneuploidies (P=1.00). The sensitivity were 11/11 and 29/29 respectively,the specificity were 99.90％(2982/2985) and 99.89％(5472/5478), the positive predictive value (PPV) were 78.57％(11/14) and 82.86％(29/35), the negative predictive value (NPV) were 100％(2982/2982) and 100％ (5472/5472), respectively. Besides, the sensitivity and PPV of NIPT for SCA were 100％ and 41.18％. No false negative was found. Conclusions The proportion of pregnancies underwent NIPT alone was 64.77％. NIPT had excellent performance (the specificity and PPV) for common aneuploidies, and also had a certain value for SCA, which greatly reduced in invasive diagnosis. NIPT is a commendable essay as a first-line prenatal screening. Invasive diagnosis is still necessary for pregnancies with high-risk of NIPT.
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Objectives To investigate the homology and drug resistance gene of Group B Streptococcus ( GBS) Resistance induced by Clindamycin and provide basic data for clinical prevention and treatment of GBS Resistance infection induced by Clindamycin .Methods 921 strains of GBS were isolated at Obstetrics&Gynecology Hospital of Fudan University from January , 2014 to December , 2015.VITEK2-compact automatic bacterial susceptibility instrument was used to test their sensitivity to 7 antibacterial drugs.63 positive strains were chosen through D-inhibition zone trial which were drug resistant to Erythromycin and susceptible or intermediary to Clindamycin .The strain′s sequence type was identified by the method of multilocus sequence typing ( MLST typing ) .The drug resistance genes mefA & ermB to Erythromycin were detected by using PCR method .The analysis was carried out to reveal the relevance to drug resistance , multilocus sequence typing and drug resistance gene .Results Among 921 strains of GBS , the drug resistance rate was respectively 53.4％ ( 492/921 strains ) to Erythromycin , 50.2％ ( 462/921 strains) to Clindamycin, 34.7％ ( 320/921 strains ) to Levofloxacin and 7.5％ ( 69/921 strains ) to Nitrofurantoin.The drug resistance rate of Levofloxacin for 63 GBS strains was 27.0％(17/63 strains) and no drug resistant strain was found to Penicillin , Vancomycin & Nitrofurantoin.12 different ST types were involved in total, including a new ST type:ST1072.The most common ones were ST12 (30.1％) (20/63 strains) &ST19 (25.4％) (16/63 strains).The drug resistance rate of Levofloxacin with ST 19 (75.0％) (12/16 strains) was much higher than that of other ST types .The relevance ratio of mefA and ermB among 63 GBS strains was respectively 27.0％(17/63 strains) and 41.3％(26/63 strains).Conclusions The genetic diversity existed in Group B Streptococcus resistance induced by Clindamycin detected in this study . There was significant difference on drug resistance and relevant drug resistant genes among different ST types.
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Objective To investigate the prevalence and transmission mechanisms of plasmid-mediated blaoxa-23 resistance genes in Acinetobacter baumannii.Methods One hundred and one Acinetobacter baumannii were collected from Obstetrics and Gynecology Hospital of Fudan University and Renji Hospital Shanghai Jiaotong University School of Medicine.Antibiotic susceptibility of carbapenems were determined by standard agar dilution method.Molecular typing of Carbapenem-resistant Acinetobacter baumannii (CRAB) was performed by MLST.blaoxa-23、blaoxa-24、blaoxa-51、blaoxa-58、blaIMP-1、blaVIM-1/2 and blaAmp-C were analyzed by PCR.The analysis of blaoxa-23 transposons for carbapenems resistant A.baumannii isolates was also performed by PCR.Plasmid was analyzed by gel electrophoresis.Conjugation experiments were performed to determine the transferability of blaoxa-23.Results The antibiotic susceptibility tests showed the resistant rates to carbapenems were extremely high , and the ones of imipenem and meropenem were 64.4%and 69.3%.Fifty-six (53%) isolates were carbapenems-resistant A.baumannii.Main clone ST208 includes 28 isolates(50%) in CRAB.A total of the CRAB isolates harbored blaoxa-23 and blaoxa-51 (100%), 44 for blaIMP-1(78.6%) and 54 for blaAmp-C(96.4%), while blaoxa-24, blaoxa-58 and blaVIM-1/2 was undetected.Two previously identified transposons ( Tn2006 and Tn2008 ) was found in the isolates.Plasmid gel electrophoresis results showed that the isolates carried 2-4 plasmids and blaoxa-23 were transferable by plasmids.Conclusions There is high carbapenems resistance of A.baumannii infections.ST208 was the most prevalent molecular type.The mainly drug-resistant genes of A.baumannii are blaoxa-23.Based on the findings, blaoxa-23 is plasmid mediated, suggesting that it may transfer by plasmids carrying Tn 2008 transposon, thus induced isolates resistant to carbapenemase.
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Objective To explore the clinical features of spontaneous intracranial hypotension (SIH) headache. Methods Thirty-six cases with SIH headache who were admitted between August 2009 and September 2014 were retrospectively analyzed. Results Twenty-five (69.4%) of 36 cases were female, and 11 cases (30.6%) were male. The age of onset was (39.6 ± 11.9) years. All the cases had headache, among whom 91.7% (33/36) had typical postural headache. The common concomitant symptoms were nausea, vomiting and neck stiffness. The average cerebrospinal fluid (CSF) pressure was (45.3 ± 28.6) mmH2O (1 mmH2O=0.009 8 kPa) which in male was (67.4 ± 15.4) mmH2O , and in female was (37.3 ± 28.2) mmH2O, and there was significant difference (P<0.05). The content of CSF protein was (545.6 ± 377.1) mg/L and the level of IgG was (57.4 ± 41.1) mg/L. Seventeen cases showed abnormality on MRI scan, with diffuse pachymeningeal enhancement, subdural hematoma, hyperemia and swelling pituitary. Eleven cases (52.4%, 11/21) showed abnormal on EEG examination, with theta waves and epiletiform waves in bilateral cerebral hemisphere. All cases were cured after conservative treatment, 3 cases relapsed within 1 month and was cured again. Conclusions Typical postural headache, cerebrospinal fluid pressure less than 60 mmH2O, higher levels of CSF protein and IgG, diffuse pachymeningeal enhancement and hyperemia and swelling pituitary on MRI scan are the main features in SIH headache, and this disease has favorable prognosis.
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Objective To investigate the resistance rates of the Candida albicans strains isolated from patients with vulvovaginal candidiasis to 5 antifungal agents and examine the mechanism of azole resistance in these strains.Methods A total of 1 646 C.albicans strains were collected in Obstetrics and Gynecology Hospital of Fudan University from January to December 2015.The resistance rates of these isolates to five antifungal agents were analyzed.Azole-resistant (n=30),dose dependent sensitive (S-DD) (n=13),and susceptible isolates (n=10) were randomly selected from the microbiology laboratories of three obstetrics and gynecology hospitals in Shanghai.The expression levels of drug efflux pump related gene CDR1,CDR2,MDR1 and drug target enzyme gene ERG11 were analyzed by real-time fluorescence quantitative polymerase chain reaction (PCR).At the same time,the ERG11 and ERG3 genes were amplified by PCR and sequenced,and analyzed for resistance-related mutations.Results Of the 1 646 C.albicans strains,5.2％,3.2％,2.5％ and 2.1％ were resistant to itraconazole,voriconazole,fluconazole and 5-fluorocytosine,respectively.All isolates were sensitive to amphotericin B.The expression of ERG11 gene was significantly higher in S-DD group and azole-resistant group than in azole-sensitive group (P＜0.05).The expression of CDR1,CDR2 and MDR1 did not show significant difference among the three groups.There were 13 missense mutations in the ERG11 gene,of which T123I,P98S and Y286D amino acid substitutions were newly discovered.Both T123I and Y132H were identified in 26 resistant isolates,of which 16 gene mutation was detected in two pan-azole-resistant isolates.Conclusions The C.albicans strains isolated from vulvovaginal candidiasis showed higher resistance rates to azole antifumgal agents than that to 5-fluorocytosine and amphotericin B.Mutation and over-expression ofERG11 gene may be one of the prevalent molecular mechanisms underlying azole resistance in C.albicans.were pan-azole-resistant.In addition,the ERG3 heterozygous
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Objective To analyze the serious complications of transurethral resection of the prostate (TURP).Methods A retrospective study was conducted to summarize the clinical data of 1950 patients with benign prostatic hyperplasia from January 2005 to December 2014.All patients received TURP.The mean patient Age,disease course,IPSS score,PV and Qmax of 1 950 eligible patients were 71 years (54 to 87 years),7.6 years(0.5 to 15.0 years),(65.1 ±33.4)ml,25.5 ±3.9 and (8.1 ±2.6)ml/s,respectively.Intraoperative and postoperative complications were graded according to the CLASSIC and modified Clavien classifications,respectively.Serious complications were defined as grade Ⅲ or higher.Results Among the TURP procedures,99 serious complications occurred,resulting in a serious complication rate of 5.1％,Serious intraoperative and postoperative complication rates were 1.2％ (24 cases) and 3.9％ (75 cases),respectively.Serious intraoperative complications included ureteral orifice injury (3 cases),bladder explosion (4 cases),and transurethral resection syndrome (17 cases).Serious postoperative complications included massive hemorrhage (26 cases),severe dysuria (18 cases),permanent urinary incontinence (4 cases),cardio-cerebral vascular accident (5 cases),pulmonary thrombosis (3 cases),severe infection(18 cases),and death (1 case).Conclusions Serious complications may occur at any stages during TURP.Understanding the causes and characteristics of complications,strengthening the prevention and effective treatment is the key measure to reduce the incidence rates.
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Objective To simulate the chemical microenvironment of traumatic brain injury (TBI) under mild hypothermia, and investigate the effect of such microenvironment on umbilical cord mesenchymal stem cells (UCMSCs) in vitro.Methods Eighteen SD rats were allocated to shamoperated group, TBI group and mild hypothermia group according to the random number table, with 6 rats per group.Rat models of TBI were made by electric cortical contusion impactor.After systemic mild hypothermia (33℃) for 4 h, brain tissue homogenate extracts were harvested.Polyacrylamide gels mimicking the elastic modulus of brain were manufactured.Human UCMSCs were isolated and cultured on the gels, added with brain tissue extracts from each group.After 24 h, the apoptosis level of UCMSCs was checked, and the medium was changed with normal one.Cell growth and morphological changes in each group were given dynamic observation.Seven days later, cell immunofluorescence was implemented, with the differentiation level of each group estimated.Results Apoptotic rate in TBI group was 73.47％,significantly higher than 10.42％ in sham-operated group (P ＜0.01).While the apoptotic rate was 28.57％ in mild hypothermia group, indicating mild hypothermia significantly reversed the apoptosis of cells in TBI group (P ＜ 0.01).Cell immunofluorescence demonstrated rate of neuronal differentiation of UCMSCs in sham-operated group, TBI group and mild hypothermia group was 16.48％, 2.59％ and 11.83％ respectively.Mild hypothermia resulted in significantly improved neuronal differentiation of UCMSCs after TBI (P ＜ 0.05).Conclusions More apoptosis and lower neuronal differentiation ability are observed in UCMSCs in the chemical microenvironment after TBI.However, mild hypothermia significantly reverses the elevation of apoptosis and restores the neuronal differentiation capacity of UCMSCs after TBI.
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Objective To investigate the clinical application value of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney.Methods Fifty-four cases of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney were reviewed,including 9 cases with nonfunctioning tuberculosis pyonephrosis,18 cases with infection nonfunctioning pyonephrosis and 27 cases of nonfunctioning hydronephrosis.Fifty-four cases were received retroperitoneal laparoscopic nephrectomy,tuberculous and infection pyonephrosis underwent laparoscopic resection surrounding adipose capsule,nonfunctioning hydronephrosis underwent laparoscopic resection by pumping water to increase the peritoneal space.Results The operation of 54 cases were perfomed successfully.None of the patient required conversion to open surgery.During the surgery,1 case showed mild extravasation of cheese-like pus induced by laceration of the kidney capsule;2 cases had injuried on the peritoneum.The mean operation time was 125 (95-230) min,the mean blood loss was 84 (50-420) ml.All patients showed primary healing of the wound,the patients were discharged from the hospital in 6 to 11 d (mean 7.5 d).After followed up for 5-27 months,none of them had long-term complication.Conclusions Retroperitoneal laparscopic nephrectomy for nonfunctioning kidney has advantages of minimal invasion,less blood loss and quicker recovery,so it is a fairly safe and effective procedure for nonfunctioning kidney.
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Stem cells transplantation had been proved to be effective in many clinical diseases. However, microenvi-ronment can influence their growth, migration and differentiation. Under chemical microenvironment, such as hypoxia, neu-ral growing factors and different kinds of ions, stem cells had been intensively studied while little is known about their perfor-mance under physical microenvironment. The effects of mechanical forces, elasticity and rigidity of the matrix of stem cells are still to be further investigated. This article is to summarize how microenvironment controls the fate of stem cells and to re-view the measurement of the mechanical properties.
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Objective To analyze the clinicopathological characteristics, immunophenotypes and immu-noglobulin heavy chain gene rearrangement of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Methods The clinical data of 35 patients with gastric MALT lymphoma who had been admitted to Southwest Hospital from January 1984 to June 2003 were retrospectively analyzed. The specimens of the gastric MALT lymphoma were obtained and their pathomorphological classifications were studied. The immunophenotypes and immunoglobulin heavy chain gene rearrangement were detected by immunohistochemistry and polymerase chain reaction, respectively. All the data were analyzed by chi-square test and Mann-Whitney U test. Results The main manifestations of patients with gastric MALT lymphoma were epigastric discomfort and abdominalgia. The percentage of patients with age≥40 accounted for 74% (26/35). The gastric MALT lyrnphoma has low differentia-tion in 32 patients, and high differentiation in 3 patients. There were 31 patients in Ⅰ E stage, 2 in Ⅱ E1 stage and 2 in Ⅳ stage. Pathological examination showed that gastric MALT lymphoma was composed of centrocyte-like cells and mononuclear-like B cells or lymphoplasma cells. Twenty-nine specimens were with lymphoepithelial lesions (83%), 2 with follicular colonization (6%), and 11 with plasma cells segregated beneath the surface epithelium (33%). All the 35 specimens were B cell immunotype. Restrictive expression of κ and λ light chains of the immunoglobulin was found in 19 cases, and Bcl-2 positive expression was found in 16 cases. High expres-sion of proliferating cell nuclear antigen was found in gastric MALT lymphoma with transformed blasts, which indicated that gastric MALT lymphoma with transformed blasts was more active in proliferation than those of low grade. A monoclonal pattern of immunoglobulin heavy chain gene rearrangement was detected in 33 patients (94%). Conclusions Digestive symptoms are the main manifestations of patients with gastric MALT lymphoma. The incidence of gastric MALT lymphoma increases with age. The final diagnosis of gastric MALT lymphoma depends on the pathological, immunohistochemical examination and laboratory test.
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Objective To study the transformation of myosin isoforms and the effect of verapamil on the transformation after burn. Methods Wistar rats were randomly divided in four groups: the burn group(BG, inflicted with 30% TBS third degree burn), the verapamil group(VG), the fluid replacement group(RG) and the control group(CG). The transformation of myosin was observed by SDS PAGE. Results The transformation of myosin from V1 to V3 in three experimental groups was found at the 12 th hour(at 24 th hour in verapamil group)after burn, which was significantly different from that in the control group( P 0.05). Conclusion Burn can induce the transformation of myocardial contractile protein myosin isoforms from V1 to V3, which can be partially prevented by verapamil.
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3?10 -4 mol/L), and the role was persistent if its concentration was kept. Meanwhile, the increase of intracellular free Ca 2+ induced by stretch was also inhibited by NO. Conclusion Cardiocytes hypertrophic response stimulated by stretch could be inhibited by nitric oxide. The inhibitory effect might be due to the decrease of the concentration of intracellular free Ca 2+ .
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<p><b>OBJECTIVE</b>To investigate the effects of postburn fluid resuscitation on the pathohistological and ultrastructural changes of multiple organs with dysfunction in severely burned dogs.</p><p><b>METHODS</b>Forty - four mongrel dogs were randomly divided into four groups: (1) immediate infusion (II, n = 8), (2) delayed infusion (DI, n = 15), (3) no infusion (NI, n = 14), (4) normal control (NC, n = 7). The dogs were inflicted with 50% TBSA III degree flame burn produced by napalm in concentration of 30g/L burning for 30 seconds on the back. Small pieces of tissue samples of heart, lungs, liver, kidneys and gastrointestinal tract were taken from injured dogs at 72 postburn hours (PBHs) or moribund stage for the examination with light microscope (LM) and transmission electron microscope (TEM).</p><p><b>RESULTS</b>Different degrees of blood circulation disturbance and degenerative changes were found in all above internal organs. These changes were more evident in DI than in II and NI groups.</p><p><b>CONCLUSION</b>Delayed postburn fluid resuscitation could induce multiple organ dysfunction in early postburn stage.</p>
Subject(s)
Animals , Dogs , Burns , Therapeutics , Digestive System , Pathology , Fluid Therapy , Kidney , Pathology , Liver , Pathology , Lung , Pathology , Multiple Organ Failure , Pathology , Myocardium , Pathology , Time FactorsABSTRACT
Objective To investigate roles of cyclin-dependent kinase 4 (CDK4) in nordihydroguaiaretic acid (NDGA)-induced inhibitory effect on proliferation of human malignant glioma cells. Methods The techniques of cell culture, cell counts, flow cytometry, immunoprecipitation, immunohistochemistry and image analysis were employed in this study. Results ①A concentration-dependent inhibition of proliferation was demonstrated in the SHG-44 cells incubated for 24 hours in the presence of NDGA, and cell proliferation was blocked in the G1→S phase. ②The activity of CDK4 was decreased apparently in the SHG-44 cells treated for 24 hours with 10 to 200 μmol/L NDGA in a concentration-dependent way. ③The expression of CDK4 gene was downregulated in the cells after NDGA treatment. Conclusion CDK4 plays an important role in NDGA-induced inhibition of glioma cell proliferation.
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Objective To investigate the changes and their significance of bcl-2 and c-myc in nordihydroguaiaretic acid (NDGA)-induced apoptosis of human malignant glioma cell line SHG-44. Methods The apoptosis of SHG-44 cells was observed with light and electron microscopy and TUNEL method. The expression of bcl-2 and c-myc gene was measured with immunohistochemistry, in situ hybridization and image analysis. Results ① The SHG-44 cell apoptosis was induced by NDGA at a concentration lower than 200 μmol/L in a time-dependent manner. ② The expressions of bcl-2 and c-myc gene in SHG-44 cells were decreased after the treatment of 100 μmol/L NDGA with the elapse of time, indicating a close association with cell apoptosis. ③ The expressions of bcl-2 and c-myc mRNA in SHG-44 cells were decreased after the treatment with 100μmol/L NDGA, which was apparently consistent with the immunohistochemical results. Conclusion The NDGA-induced apoptosis in human malignant glioma cells might be related with the down-regulated expressions of bcl-2 and c-myc gene. The exact mechanism needs further research.
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Objective To explore the effect of nordihydroguaiaretic acid (NDGA) on the expressions of vascular endothelial growth factor (VEGF) and its receptor, kinase-inserted domain containing receptor(KDR) and the possible mechanism. Methods The expression of VEGF in human malignant glioma cell line SHG-44 and that of KDR in human umbilical vein endothelial cell (HUVEC) line ECV-304 were observed 1～3 d after NDGA treatment with immunohistochemistry, in situ hybridization and image analysis. Results The expression of VEGF was declined at protein or mRNA levels in SHG-44 cells after treated with 100 μmol/L NDGA for 1 to 3 d. The expression of KDR in endothelial cells with 100 μmol/L NDGA treatment for 1 to 3 d was decreased too, in a more obvious way compared with the decline of VEGF expression in SHG-44 cells. Conclusion The results suggest that NDGA inhibits the expression of VEGF in glioma cells as well as that of VEGF receptor KDR in endothelial cells, which may be the important molecular mechanism of anti-angiogenesis of NDGA.
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Objective To investigate the effects of TNP-470 on the growth of a human malignant glioma cell line SHG-44 in vivo and in vitro. Methods The colorimetric MTT assay, soft agar culture, flow cytometry，light and electron microscopy were used to determine the proliferation, the cloning efficiency, cell cycle and the morphological changes of SHG-44 cells as well as the growth of its xenografted tumor. Results TNP-470 (20～2 000 ng/ml) significantly inhibited the proliferation of SHG-44 cells in vitro (the 50% inhibitory concentration was 200 ng/ml). Cloning efficiency reduced obviously. The number of cells in G0/G1 phase increased, while that in S, G2/M phases decreased significantly. Weight and volume of xenografted tumors treated with TNP-470 (30 mg/kg, injected subcutaneously every other day) reduced notably. Furthermore, there were necrotic area and apoptosis in the tumor. No severe side effect of TNP-470 was found in this study. Conclusion The inhibitory effect of TNP-470 on the growth of SHG-44 cells correlates with its functions of regulating cell cycle and inducing apoptosis, which suggests that the angiogenesis inhibitor TNP-470 has strong inhibitory effect on human malignant gliomas.
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Objective To investigate morphological changes of endothelial cells after nordihydroguaiaretic acid (NDGA) treatment in vitro. Methods The morphological changes of human umbilical vein endothelial cells (HUVEC) cell line ECV-304 and the cell apoptosis rate in sub-G0 phase were observed with invert, light and electron microscope and flow cytometry after NDGA treatment at different concentrations or with PBS (0.01 mol/L) as control. Results ①After the treatment of NDGA at 50～200 μmol/L for 1～3 d or up to 8 d at 100 μmol/L, ECV-304 cells tended to elongate into a shuttle-like sparse appearance and those in mitosis were decreased, indicating the suppression of cell proliferation. All these alteration was in a time-and dose-dependent manner. ②NDGA-treated ECV-304 cells displayed morphological features of apoptosis, especially at the 48th h after the treatment. With flow cytometry, the cells in sub-G0 phase were significantly increased, and reached its peak at hour 12 (20.42%) after NDGA treatment. In addition, the degeneration and necrosis of ECV-304 cells were related to the concentrations of NDGA. Conclusion NDGA can inhibit the proliferation and growth of endothhelial cells, and induce apopotosis, which might also inhibit angiogenesis.
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AIM:To study the induction of apoptosis by c-myc antisense oligonucleotide in osteosarcoma cell(MG-63).METHODS:The designed c-myc antisense oligonucleotide fragment was transfected into human osteosarcoma MG-63 cells.The cell growth and apoptosis were measured by the methods of MTT,FCM,HE staining and transmission electron microscopy.RESULTS:The results showed that the proliferation of human osteosarcoma MG-63 cells was inhibited and apoptotic rate was 37.92% when treated with c-myc antisense oligonucleotide at the does of 10.0 ?mol/L for 48 h.c-myc antisense oligonucleotide(10.0 ?mol/L) also inhibited the expression of c-myc protein.CONCLUSION:c-myc antisense oligonucleotide is able to induce apoptosis in human osteosarcoma MG-63 cells.
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Using the model of the rabbit brain ischemia the intracellular calcium accumulation and ultrastructure alteration of cerebral cortex were observed. The results indicated that the longer the ischemia reperfusion time,the more was the calcium accumulation and ultrastructure alteration in cerebral cortex. It is revealed that calcium plays an important role in the brain Injury induced by ischemia-reperfusion. The mechanism of brain injury related to calci- um was diseussed.