Expression of CD28 and cytotoxic T lymphocyte antigen 4 at the maternal-fetal interface in women with unexplained pregnancy loss.

OBJECTIVE: To investigate the expression of CD28 and CTLA-4, two costimulatory molecules involved in T-cell activation at the maternal-fetal interface in women with unexplained pregnancy loss. METHODS: A total of 57 women, 39 with unexplained spontaneous abortion (SA) and 18 with unexplained recurrent spontaneous abortion (RSA), were enrolled in the study. A high-resolution spectratyping analysis of fluorescent bands was performed to detect CD28 and CTLA-4 expression in decidual tissues. RESULTS: The mean expression of CTLA-4 mRNA was significantly higher in women with SA than in controls (P<0.05). Moreover, the expression of CTLA-4 was higher in SA patients with genotype AA and phenotype A+ (AA+AG) than in controls (P<0.01). The expression of CTLA-4 was not significantly different in patients with RSA and in controls. The expression of CD28 was significantly decreased in patients with RSA (P<0.01) and SA (P<0.05) compared with controls. The mean ratios of CTLA-4/CD28 were significantly higher in patients with RSA (P<0.01) and SA (P<0.05) than in controls. CONCLUSIONS: This study suggests that an imbalance in CTLA-4/CD28 expression or suppressed T-cell activity at the maternal-fetal interface may confer susceptibility to unexplained pregnancy loss.     

重度子癎前期终止妊娠的时机方式与结局

目前治疗子疒间前期(PE)唯一有效的方法是终止妊娠。对晚发型重度子疒间前期,胎儿已经基本成熟或接近成熟,常毫不犹豫的终止妊娠。但对于早发型重度子疒间前期,如何处理却是临床产科医师面临的难题。过多延长孕周将导致母亲严重并发症,而过早终止妊娠却又因胎儿不成熟而使新生儿并发症和死亡率大大增加。而且这些妇女再次怀孕发生早发型重度子疒间前期的机率更高,其围生儿结局依然很差。因此。应选择适宜的分娩孕周,在保证母亲安全的同时获得健康存活的婴儿。1接近足月妊娠重度子疒间前期的处理妊娠36周后的重度子疒间前期患者,控制病情的…     

脊柱爆裂性骨折的影像诊断分析

目的：分析脊柱爆裂性骨折的螺旋CT、X线表现，并提高对螺旋CT诊断脊柱损伤价值的认识。方法：回顾性分析31例39个椎体脊柱爆裂性骨折的螺旋CT扫描和X线平片征象及临床资料，其中30例行CT多平面熏建。31倒中颈椎2例，胸椎13例，腰椎16例。结果：脊柱爆裂性骨折以T12-L2最多见（占64．1％）。X线平片主要表现为椎体高度减低，脊柱屈曲后突，椎体后缘线的改变，X线平片有14例将爆裂骨折误诊为单纯压缩型骨折。螺旋CT可清楚显示脊柱骨折范围、椎管变形狭窄程度并判断脊髓损伤。X线平片和螺旋CT对爆裂性骨折的诊断率分别为54．8％和100％；椎管狭窄的显示率分别为22．6％和77．4％。结论：X线平片是脊柱损伤的基本检查手段，但有时爆裂性骨折较难与单纯压缩性骨折区分。螺旋CT检查明显优于X线平片，对脊柱骨折的诊断、分型及指导临床治疗有重要价值。     

Ultrasonographic Evaluation of Osteosarcomas

The ultrasonographic appearances of osteosarcomas and the roles of ultrasonography in the diagnosis and surgical staging of osteosarcomas were investigated. A comparative study was performed on 45 cases of osteosarcomas by ultrasonography and radiography. Bony changes, periosteal reaction and soft tissue mass were evaluated for each lesion. The results showed that ultrasonography revealed a solid mass around bone in 42 patients, bone destruction in 24 patients and periosteal reaction in 16 patients. Plain radiographs showed bony changes in 44 patients and no bony change in remaining one patient, shadowing of soft tissue swelling in 30 patients, and pulmonary metastases in 3 patients. Surgical biopsy and pathological examination confirmed osteosarcoma in all 45 patients. Soft tissue mass was confirmed in 42 patients surgically. The diagnostic accuracy of soft tissue masses by ultrasonography and radiography was 100 % (42/42) and 71.4 % (30/42), respectively. The positive rate of ultrasonography and radiography in displaying bony changes was 53.3 % (24/45) and 97.8 % (44/45), respectively. In conclusion, in the detection of soft tissue mass of osteosarcoma, ultrasonography is superior to radiography, and in displaying bony changes of osteosarcomas, radiography is superior to ultrasonography. So it may come to a conclusion that plain radiography combined with ultrasonography can completely display the bony and soft tissue lesion of osteosarcomas.     

Protective Effect of Curcumin on Endotoxin-induced Acute Lung Injury in Rats

Acute lung injury (ALI) or its more severe form, the acute respiratory distress syndrome (ARDS), is a common, devastating clinical syndrome that affects both medical and surgical patients. The most common cause of ALI is sepsis. There is now well-documented evidence that pulmonary inflammation contributes to the devel-opment of ALI. Despite significant advances in our un-derstanding of pathophysiology and technologies in the supportive management, mortality from ALI remains excessive. C…     

贫血孕妇维生素A、维生素B_2和铁营养状况及抗氧化水平的调查分析

目的分析孕期贫血妇女的血浆维生素A(VA)、维生素B2(VB2)和铁营养状况及抗氧化水平。方法将孕中期妇女分成非贫血组(Hb≥110g/L,36人)和贫血组(HB80~105g/L,426人),经知情后同意参加。采用24小时膳食回忆法了解受试者每日主要营养素摄入情况,采集空腹静脉血5ml,分析血浆VA、VB2和铁蛋白(SF)水平,超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)活性,丙二醛(MDA)和红细胞膜流动性的变化。结果贫血孕妇VA、VB2摄入不足,分别为推荐摄入量(RNIs)的58·7%和57·2%,铁的来源仍为吸收率低的植物性食物。贫血孕妇的血浆VA(1·25μmol/L)和铁蛋白(20·57μg/L)水平明显低于非贫血孕妇(VA1·57μmol/L,SF33·16μg/L,P<0·05),全血谷胱苷肽还原酶活性系数(BGRAC)(1·79)水平高于非贫血组(1·52);SOD(77·1U/ml)和GSH-Px(61·9U)活性低于非贫血组(SOD92·2U/ml,GSH-Px71·6U,P<0·05);MDA(4·58nmol/ml)和红细胞膜的P和η值(P=0·2622,η=2·7465)明显高于非贫血组(MDA3·78nmol/ml,P=0·2360,η=2·3658,P<0·05)。且随贫血程度的加重,VA、铁蛋白水平、SOD和GSH-Px活性进一步下降,BGRAC、MDA、P和η值明显升高。结论妊娠中期贫血妇女血浆VA、VB2、铁蛋白及抗氧化能力均明显低于非贫血孕妇。且随贫血程度的加重而降低。     

中国三城市非吸烟妇女被动吸烟现况及影响因素分析

目的了解非吸烟妇女被动吸烟现况及探索控制妇女被动吸烟的措施。方法采用随机整群抽样的方法,收集了北京、上海和成都3500名非吸烟妇女关于被动吸烟情况的资料,应用EpiInfo2002软件进行卡方检验、Fisher检验和方差分析等。结果被动吸烟妇女中有92·7%的人在家中接触环境香烟烟雾(ETS),40·8%的在工作场所接触ETS,其中有38·9%的被动吸烟妇女从出生时即开始被动吸烟,42·3%的从18~30岁开始被动吸烟。被动吸烟妇女平均每天接触ETS(1·17±1·10)h,其中在家中每天被动吸烟超过2h的比例明显高于在工作场所的比例。被动吸烟组中30~50岁年龄组、中等文化程度或配偶中等文化程度、已婚、服务性/商业工作人员、单位负责人以及生产运输工人的构成比显著高于非被动吸烟组中的构成比(P<0·05)。有97·5%的人认为被动吸烟可对自身健康产生危害,非被动吸烟组认为被动吸烟有严重危害的比例显著高于被动吸烟组。被动吸烟妇女中70·0%以上当有人在自己周围吸烟时会打开门窗等,而只有16·9%的人会主动要求别人不要在自己面前吸烟。假设有人在自己面前吸烟时,非被动吸烟组采取主动措施避免被动吸烟的意识显著强于被动吸烟组。被调查的妇女中有95·1%的人相信媒体关于吸烟对健康危害的宣传。结论控制被动吸烟的主要场所是家中和机关单位、商业、服务业以及生产运输的工作场所,尤其要加大对家庭中被动吸烟的控制。人们对被动吸烟危害程度的认识影响着人群被动吸烟率。利用电视和杂志等媒体进行被动吸烟对健康危害的宣传,加强人群主动避免被动吸烟的意识,是控制人群吸烟、降低人群被动吸烟率的可行性措施之一。     

抚顺市新生儿脐带血TSH水平分析

目的 了解抚顺市近几年来供应碘盐后碘缺乏病的病区出生的新生儿的碘营养情况.方法 采集农村和城区新生儿脐带血滴于滤纸上,用免疫放射法测定TSH值.结果 农村新生儿脐带血的TSH＞5 mU/L的比率非常显著高于同期城区新生儿.结论 农村孕妇的碘营养状态低于城区,农村的非碘盐的使用是造成孕妇碘缺乏的主要原因.     

阵发性心房颤动时右心房f波振幅的测量

目的:测量阵发性心房颤动(atrial fibrillation,AF)患者右心房不同部位的f波振幅,探讨在AF律状态下起搏器心房电极固定位置的选择和植入的可行性。方法:13例阵发性AF患者,窦性心律和AF时,分别把6F的4极电极导管送至高位右心房、中位右心房、低位右心房、房间隔上部、房间隔中部和冠状窦口处。利用Medtronic PSA 5311分析仪测量6F电极1～2极间的电位差。结果:(1)右心房中部和房间隔上部的f波振幅均值分别为(3．93±1．84)mV和(3．96±1．35)mV。(2)右心房中部与高、低位右心房之间的f波振幅均有明显差异(P＜0．05);房间隔上部与房间隔中部的f波振幅也有明显差异(P＜0．05)。(3)AF时f波振幅均值低于A波振幅均值(P=0．002)。结论:(1)右心房中部和房间隔上部的f波振幅值较其它4个部位的振幅高。(2)AF时f波振幅波动范围明显较大。(3)阵发性AF时,右心房中部与高位、低位右心房之间的电位均有明显差异。右心房中部和房间隔上部的f波振幅较其它部位高,可选为右心房主动固定电极的植入部位。     

资源库在医学研究生教学中的建立与应用

结合多媒体资源库的构建,介绍了资源库的构建要求以及在医学研究生教学中应用和亟需完善的一些问题。