Decrease and dysfunction of endothelial progenitor cells in umbilical cord blood with maternal pre-eclampsia

BACKGROUND: The pre-eclampsia is characterized by placental defective angiogenesis and maternal vascular/endothelial dysfunction. Recently, the decrease and senescence of endothelial progenitor cells (EPC) has been observed in maternal circulation with pre-eclampsia. Given the essential involvement of EPC in neovascularization and reendothelialization, we investigate whether or not the depletion of EPC is existent in placental/fetal circulation with maternal pre-eclampsia. METHODS: Samples of venous cord blood were collected during the labor of preeclamptic mothers (n = 14) and normotensive controls (n = 10). Circulating EPC were enumerated as AC133+/KDR+ cells via fluorescence-activated cell sorting (FACS) analysis. Additionally, EPC were expanded in vitro and identified by DiI-acLDL uptake and lectin staining by direct fluorescent staining under a laser scanning confocal microscope. EPC proliferation, migration and vasculogenesis activities were determined by MTT, modified Boyden chamber assay and in vitro vasculogenensis assay. RESULT: The placental/fetal circulating EPC numbers were significantly decreased in the pre-eclampsia group compared with the control (median, 200; range, 100-440 cells/mL vs 390; 270-440 cells/mL, P < 0.001), and after in vitro cultivation the numbers of EPC also decreased in pre-eclampsia group (19.5; 5.0-32.0 vs 39.5; 31.2-52.0 EPC/x200 field; P < 0.001). Both circulating EPC and cultivated EPC were inversely correlated with cord blood level of soluble fms-like tyrosine kinase 1 (sFlt-1). In addition, the EPC from patients with pre-eclampsia were significantly impaired in their proliferation, migration and vasculogenesis capacities. CONCLUSION: The present study documented the decrease and dysfunction of placental/fetal circulating EPC in patients with pre-eclampsia. The alteration is probably associated with the increased sFlt-1 levels in the umbilical cord blood.     

镰刀菌皮肤肉芽肿1例

报告1例镰刀菌皮肤肉芽肿。患者男,21岁。面部出现红斑、丘疹、溃烂、结痂20年,四肢皮肤疣状增生3年,面部遗留毁容性瘢痕及组织缺损。多次取不同皮损处皮屑作真菌培养,均见相同菌落生长,经菌种鉴定为镰刀菌属。皮损组织病理学检查示表皮乳头瘤样增生,表皮浅层见多量菌丝,菌丝有分隔。流式细胞仪检测发现患者细胞免疫功能低下。根据药敏试验结果采用特比萘芬治疗,其疗效正在进一步随访观察中。     

应用下腹部横纹切口腹腔镜肾切除术的术中护理

目的:探讨应用下腹部皮肤横纹切口在腹腔镜下肾切除术的手术配合经验。方法:配合下腹部皮肤横纹切口腹腔镜下肾切除术患者38例,男23例,女15例。术前进行细致充分的准备,术中熟练配合,密切观察病情。结果:38例手术均顺利完成,切口均为甲级愈合,切口长5～9cm,平均6cm。随访3～22个月,均健在。33例肿瘤患者未发现肿瘤种植转移,亦未见肿瘤复发。结论:对应用下腹部皮肤横纹切口在腹腔镜下肾切除术的患者给予密切配合可确保手术顺利完成,减少并发症的发生。     

经胸超声心动图在经心导管封堵小儿房问隔缺损中的应用

目的探讨经胸超声心动图(TTE)在经心导管封堵小儿房间隔缺损(ASD)中的应用价值.方法TTE多个切面测量46例ASD最大直径,ASD部位及周围关系,术中TTE测量ASD球囊伸展径并与X线所测球囊伸展径比较,选择Amplatzer ASD封堵器的型号、引导封堵器的放置及疗效评价.结果46例经心导管封堵的ASD中40例封堵成功,6例因术中严重心律失常、Amplatzer ASD封堵器意外脱落、ASD太大和左房长径不足以及ASD距下腔静脉太近而未能封堵成功.TTE测ASD最大径(1.43±0.68)cm与X线所测球囊伸展径(1.66±0.82)cm高度相关,(r=0.89,P<0.01),TTE术中测球囊伸展径(1.78±0.85)cm与X线测球囊伸展径高度相关,(r=0.98,P<0.01).结论TTE能很好显示小儿ASD大小、部位及其周围关系,方法简便,无痛苦,在经导管封堵小儿ASD中具有重要作用.     

研究性教学方法在病理学教学中的探索与实践

为了探索研究性教学方法在病理学教学中的应用效果,华中科技大学同济医学院病理学系充分利用现有的科研基地科研成果,将科研与教学相结合,要求学生自行设计实验、复制动物疾病模型,并围绕相关内容进行深入探讨,使学生比较主动地、全面地掌握疾病的病理变化,提高了学生的自主学习能力,初步培养了学生的科研兴趣和科研能力。     

Weighted Markov chains for forecasting and analysis Incidence of infectious diseases in jiangsu Province,China

This paper first applies the sequential cluster method to set up the classification standard of infectious disease incidence state based on the fact that there are many uncertainty characteristics in the incidence course.Then the paper presents a weighted Markov chain,a method which is used to predict the future incidence state.This method assumes the standardized self-coefficients as weights based on the special characteristics of infectious disease incidence being a dependent stochastic variable.It also analyzes the characteristics of infectious diseases incidence via the Markov chain Monte Carlo method to make the long-term benefit of decision optimal.Our method is successfully validated using existing incidents data of infectious diseases in Jiangsu Province.In summation,this paper proposes ways to improve the accuracy of the weighted Markov chain,specifically in the field of infection epidemiology.     

云南永胜县总管田村钉螺分布调查——河边田钉螺原始分布状态初步报告

云南省永胜县总管田村是1981年才发现的血吸虫病较小流行区。该村的钉嫘主要分布在河边田,在历史上河边田从未灭过螺,其钉螺的分布情况纯属原始分布状态。我们对河边田的钉螺分布状态进行了详细地调查,证实了河边田的钉螺原始分布状态呈孤立、分散的岛状分布。其状况与大理福星村的钉螺分布状态一致。     

Hysteroscopic removal of foreign bodies and its method of monitoring

Objective To evaluate transcervical removal of foreign bodies(TCRF)and to estimate the effectiveness of its monitoring methods.Methods One hundred and thirteen women were identified as having residual intrauterine devices(IUD),residual pregnancy products,unabsorbed strings and broken hooks,which were not removed during routine curettage of IUD removal.All patients were monitored using B ultrasonography while TCRF was performed.Four cases were monitored by laparoscopy simultaneously.One case was monitored by laparoscopic ultrasonography.Results Foreign bodies of one hundred and nine patients were taken out by TCRF.Uterine bleeding, amenorrhoea,discharge,abdominal pain,mlcturition and hematuria disappeared postoperatively.Fetal bones embedded into intramural uterin in four cases were not removed completely.Of these four,one became pregnant 4 months later after TCR and term delivered.One case encountered uterine perforation that was sutured by laparoscopy.Conclusions TCRF is safe and efficient.Sufficient cervical canal distension,selection of equipment and methods to be used is important for successful TCRF.As a non-invasive and effective monitoring method,B ultrasonography is the first choice to monitor for TCRF.For patients with high risk factors for uterine perforation,laparoscopic monitoring should be done simultaneously.Laparoscopic ultrasonography monitoring has both the advantages of B ultrasonography and laparoscopy monitoring,but is invasive and expensive.     

经阴道彩超引导穿刺治疗盆腔包裹性积液

目的:观察经阴道彩超引导穿刺治疗妇科盆腔包裹性积液疗效并总结开展该疗法的经验。方法:用该法治疗盆腔包裹性积液68例。尽量抽尽积液后用生理盐水反复冲洗并根据具体情况注入抗生素;其中同时注入抗粘连药物15例。术后1个月～3个月后复查,随访3个月～2a。结果:治疗后3个月复查68例中48例积液消失,20例盆腔包襄性积液均有不同程度缩小,其中直径缩小1/2以上有15例,有效率100%。结论:用该法治疗妇科盆腔包裹性积液简便安全、经济,患者痛苦少,疗效确切。     

多平面经食道超声心动图估测左心耳功能及血栓的评价

目的 评价应用经食道超声心动图(TEE)估测左心耳功能及诊断左房血栓的价值。方法 采用TEE对33例伴有或不伴有房颤患者检测左心耳容量及收缩功能，探测左房和左心耳内有无明确血栓征象。并与经胸多普勒二维超声心动图(TTE)比较。结果 33例患者中左房血栓6例，左心耳血栓6例，排除左房血栓3例。根据左心耳面积测定计算出左心耳射血分数(Efv)与左心耳峰值血流排空速度(Per)相关性良好(r=0．84)。结论 TEE不仅可定性诊断左房血栓，还可测量左心耳射血分数，房颤患者左心耳面积扩大，左心耳射血分数减低，评价左心耳功能较二维超声心动图更为准确。