HIF-1α和AAH在稽留流产患者绒毛中的表达研究

目的 研究缺氧诱导因子-1α(HIF-1α)及天冬氨酰(天冬酰胺酰)-β-羟化酶(AAH)在稽留流产患者绒毛中的表达情况,探讨其与稽留流产的关系及意义.方法 稽留流产患者50例(研究组),其中有已知可能原因的20例(研究组1),原因不明者30例(研究组2);正常早孕20例作为对照组.研究组50例按胚胎稽留宫内时间长短分为≤4周组和>4周组.应用免疫组织化学方法和计算机图像分析系统检测研究组及对照组绒毛滋养细胞中HIF-1α及AAH的表达.结果 HIF-1α及AAH在稽留流产患者及正常早孕妇女绒毛中均有表达,其表达部位主要在滋养细胞的胞质及胞核.研究组1及研究组2绒毛滋养细胞HIF-1α及AAH表达水平均明显低于对照组(P<0.05);但两组间表达水平无显著差异(P>0.05);≤4周组与>4周组之间HIF-1α表达无显著差异(P>0.05).AAH在稽留流产患者及正常早孕妇女绒毛中均有表达,其表达部位主要在滋养细胞的胞质及胞核.绒毛滋养细胞AAH表达水平在研究组1及研究组2均明显低于对照组(P<0.05);两组间表达水平无显著差异(P>0.05);≤4周组与>4周组之间AAH表达亦无显著差异(P>0.05).结论 HIF-1α及AAH在稽留流产患者绒毛中的表达均低于正常早孕妇女,其低表达可能是导致稽留流产发生的重要因素.     

孕妇ToRch感染的检查与分析

ToRch即弓形体、风疹病毒、巨细胞病毒、单纯疤疹病毒Ⅰ、Ⅱ巨型,孕妇感染这组微生物的任何一种均可造成流产、死胎、先天畸形等.随着围产医学的深入发展,ToRch综合征正受到全世界产科和儿科的重视.我所从1994年11月～1995年5月对乌鲁木齐地区的早、中期孕妇1090人进行了弓形体、994人进行了巨细胞病毒、1010人进行了风疹病毒IgM的检测,现将结果报告如下.     

稽留流产与沙眼衣原体、解脲支原体感染的相关性临床研究

目的:探索观察稽留流产与沙眼衣原体、解脲支原体感染的相关性临床研究.方法:选择2011年1月～2012年12月治疗的56例稽留流产患者作为研究对象,并与正常人工流产的54例患者进行对比研究,采取细胞培养法,对两组患者的宫颈分泌物进行解脲支原体和沙眼衣原体的检测,进行综合分析.结果:观察组中解脲支原体感染的有26例(46.4％),沙眼衣原体感染的有24例(42.9％),解脲支原体和沙眼衣原体合并感染的有6例(10.7％),对照组中解脲支原体感染的有9例(16.7％),沙眼衣原体感染的有7例(13.0％),解脲支原体和沙眼衣原体合并感染的有1例(1.9％),两组相比差异有统计学意义(P＜0.05).结论:稽留流产与沙眼表原体、解脲支原体感染密切相关,早期对于沙眼衣原体、解脲支原体的检测有利于防止稽留流产的发生.     

肾移植术后重症肺部感染的诊断与治疗

目的：探讨肾移植术后肺部感染的病原体分布及救治措施。方法：对53例肾移植术后并发重症肺部感染的临床资料进行回顾性分析。结果：病原体分布：细菌42例次（46．2％），巨细胞病毒（Cytomegalovims，CMV）21例次（23％），真菌11例次（14．3％），结核杆菌6例次（7．8％），支原体5例次（6．5％），卡式肺囊虫3例次（2．6％）。44例（83％）重症肺部感染救治成功，9例（17％）死亡。结论：肾移植术后合并严重肺部感染者病情危重，死亡率较高；可靠的病原学诊断、及时而有效的综合治疗可提高其治愈率。     

解脲支原体感染与稽留流产的关系

目的探讨解脲支原体（UU）感染与稽留流产的关系。方法采用分离培养法,分别对96例早孕稽留流产患者（研究组）和80例早孕要求终止妊娠者（对照组）进行宫颈分泌物UU培养,并对两组清宫后绒毛及蜕膜送病理检查。结果研究组宫颈分泌物UU培养阳性例数（96例,占61.46%）明显高于对照组（13例,占16.25%）,两组比较,差异有统计学意义（P〈0.05）,研究组有52例（54.16%）发生绒毛膜炎,对照组有4例（5.0%）,两组比较,差异有统计学意义（P〈0.05）。结论解脲支原体（UU）感染可通过上行传播引起宫内感染,绒毛膜炎而导致稽留流产。     

稽留流产胎儿绒毛组织细胞遗传学120例分析

目的探讨孕8~11周稽留流产的发生原因及其胚胎绒毛染色体核型分析的关联。方法对120例稽留流产孕妇(孕8~12周)的胎儿绒毛组织进行绒毛染色体培养、制备和G显带并对结果进行分析。结果 120例稽留流产胎儿绒毛染色体核型培养成功106例,失败14例,成功率为88.33%。对培养成功的核型进行分析,核型异常者32例,异常率为30.19%。其中,数目异常者31例,染色体结构异常者1例。结论染色体异常是发生稽留流产的重要原因之一,对稽留流产胎儿绒毛进行染色体分析,可为病因诊断及指导优生提供重要的依据。     

巨细胞病毒与优生

调查结果令人担忧 专家们通过血清学研究证实,约 60％的育龄妇女曾感染过巨细胞病毒;从妊娠妇女血清中分离到巨细胞病毒的百分率远高于非孕妇女。许多学者对孕妇的宫颈粘液检查后发现, 2％～ 18％的孕妇宫颈粘液中能分离出巨细胞病毒,而且其检出率随妊娠月份的增加而增高。这些孕妇分娩时,约 3％～ 12％的尿液中有巨细胞病毒。尿中有巨细胞病毒的孕妇所生的活婴中, 12％有先天性巨细胞病毒感染。 巨细胞病毒对优生优育危害极大 科学家们已经证实,巨细胞病毒的致畸作用远比其他病毒强,并可通过胎盘直接侵犯胎儿。被感染的新生儿可发…     

体外受精胚胎移植术后稽留流产56例胎儿绒毛染色体分析

目的探讨体外受精-胚胎移植(IVF-ET)术后稽留流产的发生与胎儿染色体核型异常的关系。方法取56例IVF-ET术后稽留流产孕妇(孕8~12周)的胎儿绒毛组织,进行绒毛染色体制备和G显带并进行核型分析。结果 56例稽留流产胎儿绒毛染色体核型培养成功54例,失败2例。核型异常5例,异常率为9.26%。其中数目异常4例,染色体结构异常1例。结论染色体异常是稽留流产的重要原因之一,对IVF-ET术后稽留流产胎儿绒毛进行染色体分析可为病因诊断以及优生指导提供重要的依据。     

孕妇及胎儿宫内巨细胞病毒感染的研究

近年来发现,人巨细胞病毒(HCMV)可能是宫内感染中最常见、危害最大的一种病毒,在成人中感染率为50％～80％。妊娠期感染HCMV后,约50％可通过胎盘传给胎儿,引起流产、死胎、畸形、早产、胎儿宫内发育迟缓及巨细胞包涵体病,产生神经系统损害等后遗症。HCMV宫内感染常累及胎儿肾脏,在肾小管立方上皮细胞内复制,含HCMV的脱落细胞可     

米非司酮配伍米索前列醇在稽留流产中的应用

目的观察米非司酮配伍米索前列醇在稽留流产中的应用效果。方法试验组120例患者应用米非司酮配伍米索前列醇治疗：第一天和第二天给予米非司酮片75mg,第三天给予米索前列醇片600ug,待阴道流血开始行手术。对照组120例直接行手术。比较两组的疗效。结果两组手术时间、术中、术后出血量及人流综合征发生情况比较,差异均有显著意义（P〈0．05）。结论米非司酮配伍米索前列醇应用于稽留流产是一种安全、有效的方法。     

Fatal parvovirus B19 infections: a report of two autopsy cases

International Journal of Legal Medicine - Parvovirus B19 (PVB19) commonly infects children and is usually asymptomatic. Lethal outcomes of PVB19 infection are unusual; nevertheless, the two cases...     

早期复发性流产患者血浆D-二聚体、抗凝血酶Ⅲ、蛋白C、蛋白S活性变化及分析

目的探讨早期复发性流产患者血浆D-二聚体、抗凝血酶Ⅲ、蛋白C、蛋白S活性变化情况。方法选择稽留流产且既往无流产史的患者70例为稽留流产组;稽留流产且既往有2次以上稽留流产史的患者50例为复发性流产组;选择同期行人流术且既往无流产史的患者60例为正常早孕组。对3组患者的血浆D-二聚体、抗凝血酶Ⅲ、蛋白C、蛋白S活性进行检测并比较。结果稽留流产组与正常早孕组比较,血浆D-二聚体、抗凝血酶Ⅲ、蛋白C、蛋白S活性无明显变化,差异无统计学意义(P>0.05);复发性流产组与稽留流产组及正常早孕组比较,D-二聚体水平明显升高,抗凝血酶Ⅲ活性、蛋白S、蛋白C明显降低,组间比较,差异有统计学意义(P<0.05)。结论复发性自然流产患者存在血栓形成倾向,血浆D-二聚体、抗凝血酶Ⅲ、蛋白C和蛋白S检测可预测其血栓形成事件的可能性,改善妊娠结局。     

妇产科大出血急诊栓塞治疗

目的;介绍髂内动脉栓塞术抢救妇产科大出血的初步经验。方法：产后２例,子宫全切术２例,过期流产１例,均采用Ｓｅｌｄｉｎｇｅｒ技术经股动脉选择性插管至双侧髂内动脉,经导管注入明胶海绵颗粒栓塞双侧髂内动脉。结果：栓塞术后所有病例立即止血,过期流产致凝血功能障碍全部恢复正常。结论：髂内动脉栓塞术抢救妇产科大出血是安全有效的。     

孕妇血清和胚胎组织中微小病毒B19 DNA的检出

作者建立了检测人微小病毒Ｂ１９（ＨＰＶ－Ｂ１９）的ＰＣＲ方法。两对引物（Ｐ１Ｐ２和Ｐ３Ｐ４）的设计均位于编码ＨＰＶ－Ｂ１９衣壳蛋白ＶＰ１基因区内，扩增产物分别为７００ ｂｐ和１０４ ｂｐ。比较Ｐ１Ｐ２－ＰＣＲ和Ｐ３Ｐ４－ＰＣＲ，二者均具有高度特异性和第三性，ＨＰＶ－Ｂ１９ ＤＮＡ最小检同量分别为５ ｆｇ。应用Ｐ１Ｐ２－ＰＣＲ对３２份孕妇血清和２１份胚胎组织标本进行了ＨＰＶ－Ｂ１９ ＤＮＡ的检测，结     

Computed tomography aspects of cerebral toxoplasmosis in AIDS

We followed by CT 19 AIDS patients with cerebral toxoplasmosis. Diagnosis of cerebral toxoplasmosis was assessed on radiological and clinical basis, including the therapeutic response. CT allowed to confirm brain lesions (40 lesions in 19 patients) and to follow the evolution with treatment. Analysis of the CT features of these brain lesions permits to define some characteristic findings, though not pathognomonic. These lesions share common characteristics with other granulomatous diseases or with brain abscesses. The most frequently observed features are: target lesions (74%) with contrast enhancement (95%), frequently multiple (53%), associated with a hypodense area of oedema (100%), and responsible for a mass effect (79%). Under treatment, we observed improvement in 89%, resulting either in complete disappearance of the lesions (16%), disappearance of one or more contrast enhancing (46%) or hypodense (6%) areas, or volumetric regression of the hypodensities (50%). We conclude that CT is a good first-step examination for the detection and follow-up of cerebral toxoplasmosis in AIDS patients. MRI, a method with a higher sensitivity but still less accessible, may be considered at the present time as a second-step examination for those patients with solitary lesions on CT, or for symptomatic patients with normal CT.     

Polish and American collaboration on zoonotic parasitic studies, 1960 to 1997

The Marshall Plan of 1947 kindled interest in research in Europe. The U.S. Public Health Service encouraged the use of blocked national currencies to research disease problems. The parasitic diseases were epidemic/epizootic problems in Poland. The initial project was trichinellosis. The 10-year study emphasized the natural history, epidemiology, diagnosis, and therapy of trichinellosis in Poland. The wildlife source of trichinellosis was widespread. Clinical studies discounted the effectiveness of mebendazole but found steroids useful. Taenia saginata is common in Eastern Europe. T. saginata cystericosis in cattle is not easily diagnosed. Physical examination by meat inspectors missed 50% of the infected carcasses. Taenia solium is uncommon. Giardiasis is declining in Poland. The epidemiology of giardiasis in Poland is different from that in the United States, where water-borne infections are common. A study of toxoplasmosis revealed a low prevalence in women but a high prevalence in cats. No cases were identified in 4,311 newborns.     

Efficacy of MR angiography in the detection and characterization of occlusive disease in the vertebrobasilar system

PURPOSE: The purpose of this work was to determine the efficacy of MR angiography (MRA) in the detection and characterization of occlusive disease in the vertebrobasilar system. METHOD: We retrospectively reviewed the posterior circulation registry of our institution to select 42 consecutive patients with posterior circulation ischemic symptoms who underwent both MRA and angiography. The extracranial vertebral arteries (ECVAs) were examined by two-dimensional time-of-flight MRA above the C6 level, and the intracranial vertebral arteries (ICVAs) and basilar arteries (BAs) were examined by three-dimensional time-of-flight MRA. Sixty-two ECVAs, 63 ICVAs, and 39 BAs were examined by the readers. RESULTS: Occlusive disease was seen on angiography in 22 of the 42 patients. The sensitivity and specificity values for detection of lesions in 12 ECVA, 19 ICVA, and 12 BA abnormalities were as follows: ECVA, 92 and 96% for Reader A and 100 and 90% for Reader B; ICVA, 84 and 93% for Reader A and 74 and 82% for Reader B; and BA, 100 and 88% for Reader A and 100 and 78% for Reader B. For ICVA, the sensitivity of MRA was less than that of angiography because of lesions missed by the readers at the junctional area of the extra-and intracranial MRA. MRA accurately characterized 9 of the 12 (75%) ECVA, 10 of the 19 (43%) ICVA, and 11 of the 12 (92%) BA lesions. CONCLUSION: MRA is an effective method for detection of occlusive lesions in the ECVAs and BAs. Clinically important lesions can be missed by MRA in the ICVA. MRA is more accurate in characterization of occlusive lesions in BAs than in ECVAs or ICVAs.     

Lung cancers missed at low-dose helical CT screening in a general population: comparison of clinical,histopathologic, and imaging findings

PURPOSE: To compare clinical, histopathologic, and imaging features of lung cancers missed at low-radiation-dose helical computed tomography (CT). MATERIALS AND METHODS: Eighty-three primary lung cancers were found during an annual low-dose CT screening program and confirmed histopathologically at either surgery or biopsy. Thirty-two of these lung cancers were missed on 39 CT scans: on 23 scans owing to detection errors and on 16 owing to interpretation errors. The clinical characteristics, CT features, and histopathologic findings of these missed lung cancers were correlated. RESULTS: All missed cancers were intrapulmonary, and 28 (88%) were stage IA. All 20 detection errors occurred in cases of adenocarcinoma, 17 (85%) of which were well-differentiated tumors and 11 (55%) of which were in nonsmoking women. The mean size of cancers missed owing to detection error, 9.8 mm, was smaller than that of cancers missed owing to interpretation error, 15.9 mm (P <.001). In the detection error group, the percentages of nodules with ground-glass opacity (91%) or judged to be subtle (91%) were greater than those of nodules in the interpretation error group (38% and 25%, respectively) (P <.001). In the detection error group, 83% (19/23) of cancers were overlapped with, obscured by, or similar in appearance to normal structures such as pulmonary vessels. On 14 of the 16 CT scans with which there were interpretation errors, the CT findings mimicked benign disease, and the patients also had underlying lung disease, such as tuberculosis, emphysema, or lung fibrosis. CONCLUSION: The lung cancers missed at low-dose CT screening in this series generally were very subtle and appeared as small faint nodules, overlapping normal structures, or opacities in a complex background of other disease.