尿红细胞位相在妊娠期高血压疾病早期肾损伤的应用

目的:探讨尿红细胞位相在妊娠期高血压疾病早期肾损伤的应用价值.方法:选取2019年6月—2020年2月在汕头市中心医院确诊的105例妊娠期高血压疾病孕妇,分为妊娠期高血压组(29例)、子痫前期组(33例)、重度子痫前期组(31例)、慢性高血压并发子痫前期组(12例).另外选取88名同期健康孕妇为对照组.对所有研究对象均...     

子痫前期患者胎盘组织中细胞间黏附分子1的表达

目的:检测子痫前期患者和正常孕妇胎盘组织中细胞间黏附分子-1(ICAM-1)的表达水平,探讨其在子痫前期发病机制中的作用.方法:采用免疫组化PV-9000法检测50例子痫前期患者(其中轻度子痫前期20例,重度子痫前期30例)和30例正常孕妇子宫胎盘绒毛合体滋养细胞ICAM-1的表达情况.结果:重度子痫前期患者胎盘绒毛合体滋养细胞ICAM-1的表达明显高于正常孕妇组和轻度子痫前期组(P＜0.05),轻度子痫前期组与正常孕妇组ICAM-1的表达差异无统计学意义(P＞0.05).结论:重度子痫前期患者胎盘绒毛合体滋养细胞ICAM-1的表达增强,可能通过引起母胎界面炎症反应而参与子痫前期的发病.     

血浆可溶性CD40L水平变化与子痫前期病人发病关系

目的 探讨孕妇血浆中可溶性CD40配体(sCD40L)水平变化与子痫前期发病的关系.方法 选择2008年8月-2010年6月在我院产科分娩的35例重度子痫前期孕妇(sPE组)、28例轻度子痫前期孕妇(mPE组),同期正常孕妇30例(NP组).酶联免疫吸附法检测3组孕妇血浆中sCD40L水平,同时进行临床检验指标测定,分...     

早发型与晚发型重度子痫前期的比较分析

目的:对比分析不同时期重度子痫前期的临床资料,探讨早发型重度子痫前期的特点.方法:回顾分析1996年1月至2005年6月广州医学院第二附属医院收治的146例单胎重度子痫前期患者的临床资料,按重度子痫前期发病孕周分为≤34周的早发组20例,＞34周的晚发组126例.比较两组孕妇基本情况、生育史、部分临床项目及辅助检查结果、围生儿情况.结果:(1)两组中有定期产前检查者比例、初产妇比例、孕妇有自觉症状者的比例、并发症发生率差异有统计学意义(P＜0.05).初孕妇比例差异无统计学意义(P＞0.05).两组发生胎儿生长受限(FGR)比例、低体重儿比例、死胎比例组间比较差异均有统计学意义(P＜0.05);围生儿性别男女比例早发组0.82,晚发组0.97.(2)多因素logistic回归分析显示,早发型重度子痫前期与孕妇有无正规产检、是否发生并发症相关,而与是否为初产妇无关.FGR发生与子痫前期的发病孕周呈正相关,与孕妇血红蛋白量呈负相关,而与孕妇尿蛋白量、血清白蛋白量无关.结论:重度子痫前期在不同孕周的妊娠结局有差异.早发型重度子痫前期可视为一种特殊类型的子痫前期.     

子痫前期胎盘组织PD-ECGF与MVD表达及其意义

目的 探讨血小板衍生内皮细胞生长因子(PD-ECGF)与微血管密度(MVD)在胎盘组织中的表达及其与子痫前期发病的关系.方法 选取2010年1-6月在泰安市中心医院产科住院分娩的子痫前期病人65例,其中轻度子痫前期病人30例(轻度子痫前期组),重度子痫前期病人35例(重度子痫前期组),另选同期正常孕妇35例为对照组.采...     

子痫前期患者血清sFlt-1水平及其临床意义研究

目的 分析子痫前期患者血清可溶性血管内皮生长因子受体-1(sFlt-1)水平及其与患者临床表现和预后的关系。方法 选取2019年7月至2020年6月在杭州市妇产科医院行常规产前检查和分娩的子痫前期孕妇34例为子痫前期组,另择同期在本院行常规产前检查和分娩的无高血压、肾病、糖尿病等代谢性疾病的正常相近孕龄妇女28例为对照组。抽取对照组孕妇和子痫前期组孕妇首次诊断子痫前期时的静脉血5 ml检测血清s Flt-1水平。比较子痫前期组与对照组孕妇一般资料和实验室指标。根据子痫前期组孕妇的发病时间,分为早发型子痫前期组（<34周）与晚发型子痫前期组（≥34周）,比较两组孕妇血清sFlt-1水平。根据患者有无重症表现,将子痫前期组分为重症组与非重症组,比较两组孕妇血清sFlt-1水平。以子痫前期组孕妇血清sFlt-1水平中位数为界,将子痫前期组分为高sFlt-1组与低s Flt-1组,比较两组孕妇一般资料和实验室指标;采用多因素logistic回归分析影响子痫前期孕妇血清sFlt-1水平的因素。结果 （1）子痫前期组孕妇的尿酸、平均动脉压、血清sFlt-1水平、尿蛋白阳性率、并发症及胎儿宫内...     

胎盘蛋白13检测在子痫前期患者妊娠中晚期血清中的变化分析

目的:研究探讨妊娠子痫前期患者血清中的胎盘蛋白13(PP13)含量与孕妇妊娠孕周长短的变化关系。方法:回顾性分析本院收治的44例子痫前期患者的临床资料。将其分为轻度子痫前期组16例和重度子痫前期组28例;另外选择30例正常健康孕妇设为对照组。采用ELISA检测方法测定孕妇在不同孕周时血清中的PP13的含量。结果:轻、重度子痫前期组血清中PP13的含量均显著高于正常孕妇组(P0.05);且重度子痫前期组显著高于轻度子痫前期组(P0.05);各组妊娠晚期血清中PP13的含量显著高于妊娠中期(P0.05);相对于妊娠中期,子痫前期组妊娠晚期孕妇血清中PP13含量的增加值显著高于正常孕妇组(P0.05)。结论:重度子痫前期孕妇血清中的PP13的含量高于轻度子痫前期孕妇,子痫前期患者血清中的PP13的含量高于正常孕妇,随着妊娠时间的延长,孕妇血清内PP13的含量有所增高。     

子痫前期患者肾功能的评价及临床意义

目的:探究子痫前期患者肾功能的评价及其临床意义分析.方法:选取2013年1月至2014年12月收治的84例子痫前期患者作为观察组,其中轻度子痫前期患者50例,重度子痫前期患者34例,另选取同期来我院进行产前体检的正常孕妇50例作为对照组,分析两组患者肾功能指标的差异以及临床意义.结果:子痫前期患者血肌酐、24h尿蛋白、血尿素氮以及UA的水平均显著高于对照组孕妇,且随着病情的加重,各项指标的水平也显著上升,子痫前期组孕妇肾功能参数异常的发生率要显著高于对照组孕妇,肾功能参数异常组的孕妇其围产儿不良结局发生率要明显高于肾功能参数正常组孕妇,以上差异均有明显的统计学价值(P＜0.05).各肾功能指标与围产儿不良结局均呈正相关,与血肌酐相关系数最高(r=0.74,P＜0.01).结论:血清UA等肾功能指标的水平能够作为判断子痫前期患者病情的严重程度以及围产儿不良结局的重要预测指标,有明显的临床价值.     

轻度子痫前期孕妇应用丹参注射液治疗的妊娠结局分析

目的 探讨丹参注射液对轻度子痫前期孕妇妊娠结局的影响.方法 将延安大学附属医院2010年6月至2012年6月收治的126例轻度子痫前期孕妇随机分为对照组和观察组,各63例.对照组患者给予常规硫酸镁治疗,观察组患者接受硫酸镁联合丹参注射液治疗,比较两组患者治疗前后血压、24 h尿蛋白、新生儿生存率、新生儿体质量、胎心异常率、重度子痫前期及子痫发生率.结果 两组患者治疗后的血压及24 h尿蛋白均显著下降,但与治疗前比较差异均无统计学意义（P＞0.05）;观察组新生儿生存率显著高于对照组（P＜0.05）;观察组胎心异常率、重度子痫发生率显著低于对照组（P＜0.05）.结论 在常规治疗的基础上给予丹参注射液治疗,可改善轻度子痫前期孕妇妊娠结局,提高新生儿生存率.     

脂代谢紊乱及血清脂蛋白相关磷脂酶A2(Lp-PLA2)在子痫前期的作用及相关性研究

目的:探讨脂代谢紊乱及血清脂蛋白相关磷脂酶A2(Lp-PLA2)在子痫前期的作用并研究其相关性.方法:收集2015年1月~2016年8月来我院就诊的妊娠高血压患者60例,子痫前期患者60例.并收集同时期在我院住院分娩、单胎妊娠的40例正常孕妇作为对照组.检测三组间脂代谢水平及血清脂蛋白相关磷脂酶A2(Lp-PLA2)活性.并分析A2(Lp-PLA2)与年龄、孕周、孕前 BMI脂代谢紊乱各指标的相关性.结果:研究结果表明妊娠高血压、子痫前期孕妇的TG、TC及LDL-C水平及Lp-PLA2活性均显著高于正常孕妇(P<0.05),妊娠高血压、子痫前期孕妇的HDL-C水平均显著低于正常孕妇(P<0.05),子痫前期孕妇的TG、TC及LDL-C水平及Lp-PLA2活性均显著高于妊娠高血压孕妇(P<0.05),子痫前期孕妇的HDL-C水平显著低于妊娠高血压孕妇(P<0.05);子痫前期患者血浆Lp-PLA2浓度与TC、TG 及LDL-C 正相关,而与HDL-C负相关;结论:脂代谢紊乱及血清脂蛋白相关磷脂酶A2(Lp-PLA2)在子痫前期发挥重要作用且二者具有相关性.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.