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Livestock and poultry breeding wastewater has a complex composition by diverse types and high concentrations of pollutants. The current treatment of these waste water has gradually shifted from traditional treatment to resource utilization technologies. Treatment technique based on photosynthetic microorganisms presents a financially potential alternative to traditional wastewater treatment technology, due to the water quality features and resource recovery potential of livestock and poultry breeding wastewater. This article introduced the characteristics and resource utilization trends of livestock and poultry breeding wastewater, along with the limitations of conventional wastewater treatment technologies. The advantages and disadvantages of photosynthetic microorganism-based treatment technologies and traditional methods were compared, and the principles of the technology from the perspectives of microalgae and photosynthetic bacteria were explained. Additionally, several composite treatment technologies based on photosynthetic microorganism were also highlighted, as well as value-added products that could be generated. Finally, it was proposed that photosynthetic microbial treatment technologies should aim for larger scales, integrate environmental applicability, and realize the potential for enhanced product value in the future.

Background Diabetes is an important health problem due to its high prevalence and associated disability and mortality. Research evidence provides effective information for improving patient health outcomes. Decision aids can help patients obtain evidence and increase physician-patient interaction. Objective To obtain patients' preferences for anti-diabetic drugs and develop an evidence-based decision aid to achieve the integration of evidence, patient values, and decision settings, thus facilitating patient-centered evidence-based decision making. Methods Several literature databases, like PubMed, Web of Science Core Collection, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), VIP Chinese Science Journals Database, and Wanfang Data were searched to determine the value assessment dimensions and attributes of anti-diabetic drugs. The time limit for literature search is from the establishment of the database to December 31, 2022. The questionnaires for investigating patients' preferences for anti-diabetic drugs were designed using the best-worst scaling method. Then, the empirical study to explore preferences was carried out in five hospitals in Jiangsu Province. Based on the analysis of patients' preferences, an evidence-based decision aid was developed using techniques including Vue + Element UI, Spring Boot, Spring Security, Java, etc. Results The most important five attributes in patient decisions were incidence of macrovascular complications, length of extended life years, change of health-related quality of life, incidence of microvascular complications, and control of HbA1c. The evidence-based decision aid provides a structured summary of evidence on the comparative effectiveness, comparative safety, convenience, and affordability of new anti-diabetic drugs. The multi-attribute value assessment module of new anti-diabetic drugs is the core element of the decision aid, supporting patients' evidence-based assessment of the drugs' value. Conclusion Evidence-based decision aid integrates research evidence of new anti-diabetic drugs, patients' preferences and values, and helps realize shared decision-making between physicians and patients.

By analyzing the composition and characteristics of the original lab for sensor and detection technology, and dealing with the defect of virtual experiments in the country. The paper applies 3DS MAX, Cull 3D and LabVIEW software platform to realize the bidirectional feedback 3D virtual experiments of sensors and detection technology. By the platform, the experimenters can combine the theoretic knowledge with experimental process together, cultivate their operational ability. The remote monitoring and control experiments of sensor applications are implemented by existing laboratory equipments. Moreover, the experiment can train students lo use sensor basic theory knowledge lo analyze engineering problems. [ABSTRACT FROM AUTHOR]

Traditional forensic identification relies on forensic experts to manually extract information and provide identification opinions based on medicine, biology and other fields of knowledge combined with personal work experience, which is not only time-consuming and require great effort, but also affected by subjective factors that are difficult to overcome. In the era of big data, the booming development of artificial intelligence brings new ideas to forensic medicine. In recent years, forensic researchers at home and abroad have conducted many studies based on artificial intelligence technology, such as face recognition, age and gender identification, DNA analysis, postmortem interval estimation, injury and cause of death identification, showing the feasibility and advantages of using artificial intelligence technology to solve forensic identification problems. As a new means of technology that has adapted to the development of the times, artificial intelligence has brought new vitality to forensic medicine, but at the same time also some new challenges. How to deal with these challenges scientifically and form a new mode of ‘artificial intelligence plus forensic medicine’ with artificial intelligence and forensic medicine developing collaboratively is a new direction for the development of forensic medicine in the era of big data.

Objective To explore the genetic background and structure of Urumqi Mongolians, the previously developed 39-AIM-InDels panel for ancestry inference was utilized in the present study. Methods The blood samples of 145 unrelated healthy Urumqi Mongolian individuals were collected and genotyped. The compositions of ancestry information of Urumqi Mongolians were studied with 17 different populations from three continents （East Asia, Europe and Africa） as reference populations. Then, multiple population genetics and bioinformatics analysis methods were applied, the Fst and DA values between matched populations were compared and analyzed, PCA analysis was performed and a phylogenetic tree was constructed. The proportions of ancestry information components of Urumqi Mongolians were analyzed with Structure software, etc. Results The ancestry information components of Urumqi Mongolian group in different intercontinental populations accounted for 89%, 7%, and 3% of East Asian, European, and African populations, respectively. Compared with other intercontinental populations, Urumqi Mongolian group and East Asian populations have lower Fst and DA values, and they were in the same cluster in PCA analysis as well. In a phylogenetic tree, the Urumqi Mongolian group was in the same branch as East Asian populations. Conclusion Urumqi Mongolian group had relatively close genetic relationships with East Asian populations, and the proportion of its East Asian ancestry was about 89%.

Objective To investigate the treatment outcomes,prognosis,and risk factors of treatment failure of peritoneal dialysis associated peritonitis (PDAP) caused by Klebsiella pneumoniae ,and thus provide clinical evidence for the prevention and treatment of this disease. Methods The clinical data of PDAP patients at four peritoneal dialysis centers from January 1,2014 to December 31,2019 were collected retrospectively.The treatment outcomes and prognosis were compared between the patients with PDAP caused by Klebsiella.pneumoniae and that caused by Escherichia coli. Kaplan-Meier method was employed to establish the survival curve of technical failure,and multivariate Logistic regression to analyze the risk factors of the treatment failure of PADP caused by Klebsiella pneumoniae . Results In the 4 peritoneal dialysis centers,1034 cases of PDAP occurred in 586 patients from 2014 to 2019,including 21 cases caused by Klebsiella pneumoniae and 98 cases caused by Escherichia coli .The incidence of Klebsiella pneumoniae caused PDAP was 0.0048 times per patient per year on average,ranging from 0.0024 to 0.0124 times per patient per year during 2014-2019.According to the Kaplan-Meier survival curve,the technical failure rate of Klebsiella pneumoniae caused PDAP was higher than that of Escherichia coli caused PDAP ( P =0.022).The multivariate Logistic regression model showed that long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP ( OR =1.082,95% CI =1.011-1.158, P =0.023). Klebsiella pneumoniae was highly sensitive to amikacin,meropenem,imipenem,piperacillin,and cefotetan,and it was highly resistant to ampicillin (81.82%),cefazolin (53.33%),tetracycline (50.00%),cefotaxime (43.75%),and chloramphenicol (42.86%). Conclusion The PDAP caused by Klebsiella pneumoniae had worse prognosis than that caused by Escherichia coli ,and long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP.

Objective To analyze urinary metabolites of bronchial asthma children patients with phlegm-heat obstructing Fei syndrome (PHOFS) and non-PHOFS using gas chromatography-mass spec- trometry/mass spectrometer ( GC-MS/MS) , thus performing research on syndrome markers. Methods Totally 44 bronchial asthma children patients with PHOFS and non-PHOFS in onset of asthma were recrui- ted. Another 29 healthy children were also recruited. Their urine samples were analyzed by GC-MS/MS. The profiles were analyzed using orthogonal partial least squares-discriminant analysis (OPLS-DA) , vari- able importance in the projection (VIP) , and non-parametric test to determine intergroup differential metabolites. Abnormal metabolic pathways were determined by Metaboanalyst. Results Compared with the health control group, contents of fourteen substances like inositol, uric acid, stearic acid, and so on de- creased, and mino-malonic acid content increased in asthma episode children (P <0. 05). The process was mainly involved in 5 metabolic pathways such as lysine degradation and biosynthesis, pyruvate me- tabolism, and so on. Compared with the non-PHOFS group in bronchial asthma episode, contents of nine substances like oxalic acid, L-threonine, pyrimidine, and so on decreased in the PHOFS group (P < 0. 05). The process was mainly involved in 5 metabolic pathways such as pentose phosphate pathway, inositol phosphate metabolism, and so on. Conclusions Urinary metabolites are different in infantile bronchial asthma episode and healthy children. Metabolic biomarkers and pathways exist in different syn- dromes in bronchial asthma episode.

Objective: To investigate the effect of respiratory syncytial virus (RSV)-related pulmonary infection on endogenous metabolites in large intestinal mucosa in BALB/c mice using metabolomics technology based on gas chromatography-mass spectrometry (GC-MS)., Methods: Mice were randomly divided into a control group and a RSV pneumonia model group (n=16 each). The mouse model of RSV pneumonia was established using intranasal RSV infection (100×TCID 50 , 50 μL/mouse, once a day). After 7 days of intranasal RSV infection, the mice were sacrificed and GC-MS was used to identify endogenous metabolites and measure the changes in their relative content in colon tissue. SMCA-P12.0 software was used to perform principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) for endogenous metabolites in colon tissue. The differentially expressed metabolites in colon tissue were imported into the metabolic pathway platform Metaboanalyst to analyze related metabolic pathways., Results: PCA and OPLS-DA showed significant differences between the control and RSV pneumonia model groups. A total of 32 metabolites were identified in the colon tissue of the mice with RSV pneumonia. The RSV pneumonia model group had significant increases in the content of leucine, isoleucine, glycine, alanine, arachidonic acid, and lactic acid, which were related to the valine, leucine, isoleucine, arachidonic acid, and pyruvic acid metabolic pathways., Conclusions: RSV pneumonia might cause metabolic disorders in the large intestinal tissue in mice.

Tripterygium wilfordii Hook. f. induced-hepatotoxicity was the main limitation for its usage in clinic. Qingluo Tongbi formulation showed obvious attenuation for hepatotoxicity in clinic and fundamental research in vivo. To explore the potential mechanism of the attenuation, we conducted a study on the plasma metabolomic profiles of T. wilfordii and Qingluo Tongbi formulation in rats by a sensitive gas chromatography-mass spectrometry (GC-MS/MS) method. In plasma samples, a total of 72 compounds were analyzed by EI source MS, and were successfully identified by matching NIST database. The semi-quantification results were then calculated by OPLS-DA model with SIMCA-P 13.0 software. The three groups were clearly distinguished in OPLS-DA score plot. In addition, the observation values of Qingluo Tongbi formulation showed the obvious trend towards the control levels, suggesting the detoxicity effect of the formulation. Variation metabolites were further analyzed by VIP and One Way ANOVAs, and the results showed a significant increase in compounds of glycogenic amino acids, such as alanine, proline, serine and glutamine after the administration of T. wilfordii, indicated that the tissue proteins were decomposed and amino acids were leakage into blood. Qingluo Tongbi formulation could reverse the amino acids into normal level. On the contrary, the levels of glucose, lactic acid and hydroxy butyrate decrease, and the formulation can relieve the disorder in the levels of lactic acid, suggesting the regulation of the energy metabolism. Additionally, the level of branched chain amino acid was decreased, suggested the toxicity was induced, but the formulation cannot increase it into the normal levels. Nevertheless, all the above results suggested that the classical Qingluo Tongbi formulation displayed the liver protection effect by adjusting the amino acid levels and regulating the energy metabolism. Qingluo Tongbi formulation was developed based on traditional Chinese medicine theory "detoxicity compatibility", and contained Panax notoginseng (Burk.) F. H. Chen to nourish blood and absorb clots. Modern pharmacology suggested that its liver protection effect was correlated with the promotion of protein synthesis. Another important herb is Rehmannia glutinosa Libosch., which can regulate the energy metabolism. Both were consistent with the metabolomic results in this study, which explained the potential mechanism of "detoxicity compatibility" theory. Therefore, the currently developed metabolomic approach and the obtained results would be highly useful for the comprehensive toxicity studies for other herbal medicines and various complex deoxicity formulations., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Objective: To investigate the safety and efficiency of radiofrequency ablation (RFA) in the treatment of complicated multifetal gestations., Methods: There were 6 multifetal pregnant women (gestational age ranged from 14(+6) to 27(+2) weeks) diagnosed in the Department of Obstetrics, Provincial Hospital Affiliated to Shandong University: two with twin-twin transfusion syndrome (TTTS) stage IV, one with reversed arterial perfusion sequence, one with dichorionic triamniotic triplets, one with absence of a lower limb, one with severe intrauterine growth restriction. All of them accepted ultrasound-guided selective fetocide by RFA., Results: (1) Blood flow of three reduced fetuses stopped completely after one RFA circulation, whereas the other three stopped after two circulations. One reduced fetus stopped heartbeating in 10 minutes after RFA; three reduced fetuses' heartbeats slowed down and stopped completely in 35 minutes after RFA; and the heartbeats of the other two cases stopped completely within 3 to 7 minutes after RFA. The heartbeats of the reserved fetuses were normal. All of the operations succeeded. (2) The reserved fetuses received a series of ultrasound examinations after the operations. In Case 1, the ascites of the reserved fetus, which was 4.0 cm×2.3 cm before RFA, disappeared two weeks later; and the umbilical artery systolic/diastolic (S/D) ratio, which was 3.35 before the operation, decreased to 2.70 six weeks later. Amniotic fluid depth decreased from 44.6 cm to normal two weeks after RFA. The reserved fetus received brain MRI three weeks after RFA and no abnormality was detected. In Case 2, the increased heart size (cardiothoracic ratio > 0.35) of the reserved fetus recovered to normal size ten days after the operation; and the umbilical artery S/D decreased from 4.69 to 3.39 seven days after the operation. Reserved fetuses of the other three cases were normal on ultrasound and MRI after the operations. In Case 6, the ascites of the reserved fetus, which was 2.3 cm×1.5 cm before RFA, disappeared sixteen days after the operation. The brain MRI suggested normal three weeks after the procedure. Amniotic fluid depth reduced from 11.0 cm to normal two weeks after the operation. (3) Three women delivered normal premature babies, and the other three got healthy mature infants. At present, all children are still in follow-up, and their physical examinations suggest normal., Conclusions: RFA is a safe, efficient, minimal invasive treatment, which provides a new choice for fetocide, especially for complicated monochorionic multifetal gestations. Fetocide by RFA can effectively improve the life quality of the reserved fetuses.

Objective: To compare the outcomes of multifetal pregnancy reduced to twins with initial twin pregnancy., Methods: This study included all patients who had high-order multiple pregnancies from August 2007 to September 2010 (n = 567) in outpatient or inpatient of Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University. There were 478 initial twin pregnancy (non-reduced group) and 89 multifetal pregnancy reduced to twins (reduced group). All fetal reduction procedures were performed after 12 weeks gestation. The maternal ages, gestational ages at delivery, pregnancy complications, birth weight of twins and neonatal outcomes were observed in all groups., Results: (1) Average maternal ages and mean gestational ages at delivery: the average maternal ages were (29.7 ± 4.5) and (29.9 ± 5.0) years for the non-reduced and reduced groups, respectively, no statistical significance (P = 0.755). The mean gestational ages at delivery in the nonreduced and reduced twins were (35.3 ± 3.9) and (34.4 ± 6.3) weeks, respectively (P < 0.01). (2) Pregnancy complications:the rate of pre-eclampsia was 8.2% (39/478) in the nonreduced group and 12.4% (11/89) in the reduced group, no statistical significance (P = 0.199). The rates of gestational diabetes mellitus were 1.7% (8/478) and 3.4% (3/89), respectively, no statistical significance (P = 0.287). (3) Neonatal outcomes: 1) the frequencies of birth weight discordances > 400 g were 28.9% for the nonreduced group and 27.0% for the reduced group, no statistical significance (P = 0.715). The frequencies of birth weight discordances > 100 g were 75.1% for the nonreduced group and 75.3% for the reduced group, no statistical significance (P = 0.972). 2) The mean birth weight of the nonreduced twin group was significantly higher than that of the reduced group [(2700 ± 468) g vs. (2352 ± 602) g, respectively, P < 0.01], there was statistical significance. The mean birth weight of gestational ages > 36(+1) weeks at delivery of the nonreduced twin group was significantly higher than that of the reduced group [(2809 ± 424) g vs. (2707 ± 506) g, respectively, P < 0.01], there is statistical significance. 3) The rate of infant mortality (gestational ages > 28 weeks at delivery) was 1.3% (1/78) for the reduced group and 2.2% (10/448) for the nonreduced group. The major morbidity rate was 3.8% (3/78) for the reduced group and 4.0% (18/448) for the nonreduced group, no statistical significance (P = 0.588, 0.943)., Conclusions: Multiple pregnancies after fetal reduction were still associated with a mild increased risk when compared to initial twin pregnancies and their abortion rate is high. The gestational ages of the reduced group were affected by the initial number of fetuses, and the birth weights of reduced twins were lower than that of the nonreduced twins.

Objective: To isolate and characterize the side population cells (SP cells) in the lung adenocarcinomas cell line A549., Methods: The protein expression of ABCG2 in human lung adenocarcinoma cell line A549 was detected by immunohistochemistry. SP and NSP cells in the cell line A549 were isolated by FACS, and their differentiation was analysed. ABCG2 expression in the two cell subsets was detected by RT-PCR. The cell growth curves, cell division indexes, cell cycles, plate clone formation tests, migration and invasion assays, chemotherapeutic susceptibility tests, tests of the intracellular drug levels, and the tumor cell implantation experiments on nude mice were applied to study the biological properties of the two cell subsets. The expression of ABCG2 in the transplanted tumor in nude mice was detected by immunohistochemistry and RT-PCR., Results: The positive rate of ABCG2 expression in the A549 cells by immunohistochemistry was 2.13%. SP and NSP cells were isolated by FACS. The SP cells could produce both SP and NSP cells, while NSP cells only produced NSP cells. SP cells expressed ABCG2, but NSP cells did not. The proliferation and migration abilities of the two cell subsets were similar, but the invasion and tumorigenic ability of SP cells was significantly higher than that of NSP cells. The susceptibilities to DDP and its intracellular levels of the two cell subsets were similar, but the susceptibilities to 5-FU, VP16, NVB and GEM and their intracellular levels of NSP cells were significantly higher than those of the SP cells., Conclusions: SP cells in the human lung adenocarcinomas cell line A549 is enriched with tumor stem cells. An effective way to get lung adenocarcinomas stem cells is to isolate SP cells by FACS.

Objective: To explore the distribution and characteristics on genotype of Mycobacterium tuberculosis and the relationship between Beijing genotype and drug-resistant phenotypes in Tianjin city., Methods: 656 clinical strains were collected from Tianjin Center for Tuberculosis Control and ten other Tuberculosis Institute in Tianjin from January 2008 to June 2009. Information regarding administration, clinical as well as laboratory findings of patients were collected. Proportion method was adopted to detect the susceptibility on four anti-tuberculosis drugs, namely streptomycin (SM), isoniazid (INH), rifampicin (RFP) and ethambutol (EMB). Both Beijing and non-Beijing genotypes were differentiated by multiplex PCR. The relationship between Beijing genotype and drug-resistant phenotypes was analyzed., Results: In this study, the overall resistance rate of MTB was 26.98%, with multidrug-resistant rate was 6.25%. Among 656 MTB strains, 600 isolates (91.46%) belonged to Beijing genotype. There was significant difference between Beijing and non-Beijing genotype (χ(2) = 4.26, P = 0.039) among the Tianjin household registered population. Concerning the drug resistance, there was no significant difference between the two groups., Conclusion: Beijing genotype strains were the predominant one in Tianjin. The proportion of people infected with the Beijing genotype strains in Tianjin household registration of patients was significantly higher than the proportion of patients in the floating population in the same region. Results from the statistical analysis did not reveal any statistically significant association between Beijing genotype and drug resistance.

The metabolic transformation of the drugs containing carboxylic acid groups can lead to the formation of acyl glucuronide metabolites through catalysis by glucuronosyltransferase, and produce pro-acyl glucuronide intermediate metabolites with electronic activity. Then, protein or DNA adducts appeared after a series of non-enzyme or enzyme reactions. These adducts would change the protein activity and potentially lead to idiosyncratic and genotoxicity. In this paper, we discussed the chemical activity, drug-induced mechanisms, distribution and toxicity resulting from this metabolic activation for these drugs, and stated the status and prospects of research in this field.

Objective: To investigate significance and correlation of free fetal DNA (fDNA) and beta-human chorionic gonadotropin (beta-hCG) in circulation in pregnant women with high-risk of Down's syndrome (DS)., Methods: Pregnant women with a male fetus at second trimester screening for Down's syndrome were chosen, including 5 women with a trisomy 21 fetus (DS group), 21 women with DS high-risk pregnant women (DS high-risk group) matched with 22 normal pregnant women as control group. Free fDNA in maternal plasma were extracted. Male DYS14 gene was labled as fDNA, real-time PCR was used to detect fDNA expression. The concentration of beta-hCG in maternal serum was detected by chemiluminescence immune assay. The relationship between level of free fDNA and beta-hCG concentration was analyzed by Pearson correlation analysis., Results: (1) The mean level of free fDNA was (127 +/- 58) GE/ml in DS group, which was significantly higher than (78 +/- 28) GE/ml in DS high-risk group and (48 +/- 21) GE/ml in control group,respectively (P < 0.01). When compared the level of free fDNA between DS high-risk group and control group, it reached statistical difference (P < 0.01). (2) The mean concentration of beta-hCG was (97 +/- 43) kU/L in DS group, which was significantly higher than (58 +/- 25) kU/L in DS high-risk group and (38 +/- 19) kU/L in control group, respectively (P < 0.01). The level of beta-hCG in DS high-risk group was also significantly higher than control group (P < 0.01). (3) The positive relationship between the level of free fDNA in maternal plasma and beta-hCG concentration in maternal serum was observed among three groups (r = 0.83, P < 0.05; r = 0.76,P < 0.01; r = 0.86,P < 0.01)., Conclusions: Free fDNA in maternal plasma might be a candidate marker used for prenatal DS screening. However, its clinical value need to be evaluated because of positive correlation between free fDNA and beta-HCG in maternal circulation.

Objective: To investigate the effects of anticardiolipin antibodies positive serum from patients with recurrent pregnancy loss on the proliferation of BeWo cells as well as the modulation of heparin on the growth of BeWo cell., Methods: Thirty patients with recurrent pregnancy loss whose anticardiolipin antibodies were positive and thirty healthy women with a history of term delivery were selected. Their sera were separately added to BeWo cell culture systems which contained either heparin or not. After 24 hours, the PCNA and 490 nm A value were detected by immunofluorescence and methyl thiazolyl tetrazolium (MTT), and the proliferation of BeWo cell was evaluated., Results: In the culture systems with heparin and normal serum, normal serum, heparin and serum with positive autoantibody, serum with positive autoantibody, the mean fluorescence gray scale values of PCNA were 34.8 +/- 3.1, 33.8 +/- 1.8, 33.4 +/- 2.2 and 25.1 +/- 2.3, the 490 nm A values were 0.0560 +/- 0.0033, 0.0535 +/- 0.0024, 0.0524 +/- 0.0027 and 0.0350 +/- 0.0040, respectively., Conclusions: The serum with anticardiolipin antibodies from patients with recurrent pregnancy loss can influence the prospective potency of BeWo cell, inhibit cell proliferation in vitro. Through this direct effect on biological behaviour of the trophoblastic cell, it will lead to recurrent pregnancy loss, whereas heparin can increase the ratio of pregnancy by reversing such effects in those patients.

Objective: To investigate the operative indication, timing, method, selective standards of feticided fetus and the number of reduced fetuses of selective multifetal pregnancy reduction in second trimester, and the pregnancy outcome of multifetal pregnancy by this operation., Methods: Trans-abdominal selective multifetal pregnancy reductions in 37 cases of multiple pregnancy (twins 6 cases, triplets 21 cases, quadruplets 8 cases, and quintuplets 2 cases) during 12(+1) - 25 weeks were performed under ultrasound guidance. The fetus to be reduced was injected potassium chloride (KCl) intracardiacally until the fetal heartbeat stopped gradually. Totally 46 fetuses were reduced. Periodic prenatal examination and monitoring of coagulation function were carried out after the procedure. The pregnancy complications and pregnancy outcome of all cases were recorded., Results: (1) The successful ratio of reduction was 100% (46/46 fetuses) and the successful pregnancy ratio was 88.9% (24/27). (2)Among all the 37 cases, fifteen delivered after 36 weeks, seven delivered in 32 - 36 weeks, three delivered in 28 - 32 weeks, two aborted after feticide, and ten cases were in pregnancy at the time of this study. The mean gestational age of all was (34.9 +/- 4.1) weeks, and the delivery ratio after 28 weeks was 92.6% (25/27). (3) The mean birth weight of singletons was (3014 +/- 640) g, and of twins was (2557 +/- 573) g. The neonates of three triplets all died except for in one case two fetuses were alive. (4) Except in two cases after reducing one fetus of monoamniotic twins, another one died within 24 hours, the remaining fetuses were all alive. (5) Pre-eclampsia occurred in three cases. None of the cases had blood coagulation disturbances., Conclusion: (1) Selective multifetal pregnancy reduction in second trimester can feticide the abnormal fetus objectively or reduce the fetal number effectively. It is a safe procedure to decrease the complications of multifetal pregnancy and increase the birth weight. (2) If the intention is reducing the fetal number, we choose the fetus who lies in the fundus uteri and reduce the multifetal pregnancy to twins. (3) It is advised to aviod performing the procedure during vaginal bleeding. We reduce fetus after vaginal bleeding stops for one or more weeks. (4) Selective second-trimester multifetal pregnancy reduction will not result in the disturbance of blood coagulation and the death of remaining fetus. The incidence of pre-eclampsia is decreased after multifetal pregnancy reduction.

Background: To maximize the preservation of functional pulmonary parenchyma and improve the quality of life of patients with centrally located lung cancer, trachea-bronchoplasty has been used in clinical application with good efficacy. The aim of this study is to explore the appropriate admission and management of trachea-bronchoplasty and prevent complications of trachea-bronchial sleeve resection in the treatment of centrally located lung cancer., Methods: Seventy-six patients with central lung cancer, who were treated with trachea-bronchoplasty from June, 1988 to October, 2004, were analyzed. There were 49 cases of squamous cell carcinoma, 16 adenocarcinoma, 7 adenosquamous carcinoma, 3 small cell lung cancer and 1 adenoid cystic adenocarcinoma. Seventeen patients were in stage I, 39 in stage II, 17 in stage IIIA and 3 in stage IIIB. There were 55 cases of sleeve lobectomy, 12 lobectomy with wedge resection of the main bronchus, 8 big arc resection of superior lobar bronchus-main trachea-lateral wall of trachea, 1 resection of right upper lobe-right main bronchus-carina-lateral trachea and carinal reconstruction., Results: Postoperative complications happened in 7 patients. Pneumonia and atelectasis occurred in 6 cases, in which 1 died of heart and respiratory failure. Another one died of haemorrhage of upside alimentary canal. Seventy-one patients were followed up (93.4%). The 1-, 3-, 5-year survival rate was 82.4% (56/68), 57.8% (26/45) and 41.7% (15/36) respectively., Conclusions: The trachea-bronchoplasty can not only preserve functional pulmonary parenchyma as much as possible and improve the quality of life of patients, but also provide an operative opportunity to those patients with poor pulmonary function in the treatment of centrally located lung cancer.