Progesterone, selected heavy metals and micronutrients in pregnant Nigerian women with a history of recurrent spontaneous abortion

Background

Environmental and endocrine factors have been implicated in the aetiology of recurrent abortion, with poorly understood roles. Luteal phase insufficiency marked with insufficient progesterone secretion has been reported.

Objective

To define the involvement of progesterone, trace metals, and Vitamin E in pregnant women with history of recurrent spontaneous abortion.

Methods

Convenience sampling method was used to recruit 69 pregnant women aged 21–41 years with gestational age of 0–20 weeks in this case-control study. Thirty five (cases) and thirty four (controls) had previous and no history of recurrent spontaneous abortion respectively. Demographic characteristics and 10mls of blood samples were obtained from each subject. Serum obtained was used for the determination of progesterone, zinc, copper, selenium, iron, magnesium, manganese, chromium, lead, cadmium, and serum vitamin E by standard methods.

Results

Results showed statistically significant decreases (p<0.05) in the serum zinc, copper, and vitamin E and a significant elevation (p<0.05) in the serum selenium, lead, and cadmium in cases compared with controls. Insignificant decrease (p=0.07) was observed in the serum progesterone when cases were compared with controls.

Conclusion

Results suggest that elevated serum heavy metals (cadmium and lead) and reduction of essential micronutrients (zinc, copper and vitamin E) may contribute to recurrent spontaneous abortion.     

Survivin蛋白及β-catenin蛋白在原发性肝癌组织中的表达及其临床意义

目的：研究肝癌组织中克隆细胞凋亡抑制蛋白（survivin蛋白）及β-连环素蛋白（β—catenin蛋白）的表达及其临床意义。方法：应用免疫组织化学染色法对47例原发性肝癌组织、10例肝硬化组织、4例正常肝组织中survivin蛋白及β-连环素蛋白（β—catenin蛋白）的表达情况进行检测，并结合原发性肝癌临床生物学特性进行分析。结果：在正常肝组织中survivin蛋白无表达、β-catenin蛋白无异常表达；在肝硬化组织中，survivin蛋白无表达、有2例（20％）β—catenin蛋白出现异常表达；在47例肝癌组织中有30例（63．8％）survivin蛋白表达阳性，31例（65．9％）β—catenin蛋白出现异常表达（P〈0．01）。Survivin蛋白、β—catenin蛋白表达与患者的年龄、性别、肿瘤大小无关。Survivin蛋白在原发性肝癌复发组的表达率为92．9％（26／28），无复发组的表达率为21．1％（4／19）；β—catenin蛋白在原发性肝癌复发组中的异常表达率为89．2％（25／28），在无复发组的表达率为31．6％（6／19）（P〈0．05）。在survivin蛋白表达阳性的30例原发性肝癌组织中有28例（93．3％）β-catenin蛋白出现异常表达，而在β—catenin蛋白出现异常表达的31例原发性肝癌组织中有28例（90．3％）survivin蛋白表达阳性，两种蛋白在原发性肝癌组织的表达具有一致性，且呈正相关（r=0．6324）。结论：Survivin蛋白与β-catenin蛋白与原发性肝细胞癌复发密切相关，它们可能成为预测肝癌术后有无复发的一项指标。Survivin蛋白与β-catenin蛋白的表达在原发性肝细胞性肝癌中具有密切的关系，且呈正相关。     

Long-term follow-up of Intacs from a single center

PURPOSE: To evaluate the long-term visual results in patients having Intacs placement for the correction of mild myopia. SETTING: Department of Ophthalmology, Mount Sinai School of Medicine and the Mount Sinai Hospital of Mount Sinai NYU Health, New York, New York, USA. METHODS: Patients with mild myopia (spherical equivalent between -0.75 and -4.50 diopters [D]) were enrolled to have Intacs placement between May 1995 and March 1999 under United States Food and Drug Administration Phase II and Phase III clinical trials for intrastromal corneal ring segments (ICRS). Six insert thicknesses were evaluated: 0.21, 0.25, 0.30, 0.35, 0.40, and 0.45 mm. The long-term results evaluated were uncorrected visual acuity (UCVA), maintenance of best spectacle-corrected visual acuity (BSCVA), predictability and stability of the refractive effect, induced manifest refraction cylinder, slitlamp findings, self-reported visual symptoms, and maintenance of mesopic contrast sensitivity. RESULTS: One hundred fourteen eyes of 73 patients were enrolled; 113 eyes of 72 patients received Intacs. There were no serious intraoperative or postoperative complications. The mean follow-up was 17.5 months +/- 8.9 (SD). At the end of this period (number of eyes evaluated = 100), the UCVA was 20/40 or better in 95 eyes (95.0%), 20/20 or better in 72 (72%), and 20/16 or better in 41 (41%). None of the 113 eyes lost 10 or more letters or 2 or more lines of preoperative BSCVA. The mean change in the cycloplegic refraction spherical equivalent for the 6 insert thicknesses was as follows: -0.75 +/- 0.00 D for 0.21 mm; -1.17 +/- 0.42 D for 0.25 mm; -2.00 +/- 0.54 D for 0.30 mm; -2.59 +/- 0.53 D for 0.35 mm; -3.09 +/- 0.54 D for 0.40 mm; and -3.82+/-0.80 D for 0.45 mm. The refractive correction was within +/-1.0 D of the predicted outcome in 103 eyes (92.0%) and within +/-0.5 D in 72 eyes (63.7%). Intacs were removed from 6 eyes (5.3%). All 4 eyes for which data were available 3 months after removal returned to within +/-0.5 D of their preoperative manifest refraction spherical equivalent. Intacs were exchanged because of undercorrection in 2 eyes (1.8%). These eyes gained 3 and 5 lines of UCVA 12 months and 18 months, respectively, after the exchange procedure. Overall, 85.7% (36/42) of the patients were satisfied with the results of the Intacs procedure. CONCLUSION: Intacs safely and effectively corrected mild myopia. Placement is a brief, easy outpatient procedure. The refractive effect was predictable and stable over long-term follow-up. Results from a limited number of removal and exchange procedures indicate that Intacs are removable and adjustable.     

血清乙型肝炎病毒DNA定量在慢性乙型肝炎病毒感染的临床意义

目的:测定慢性HBV感染不同状态时血清HBV-DNA水平,阐明其在判断病情和指导治疗中的价值。方法:共90例慢性HBV感染患者接受研究,共中HBeAg阳性无症状携带者(ASC)15例,HBeAg阳性慢性肝炎(CHB)17例,HBeAg阴性CHB14例,HBeAg阴性ASC16例;另有28例HBeAg阳性CHB接受干扰素治疗。血清HBV-DNA浓度测定应用AG-9600Amplisensor荧光PCR定量系统,测定范围定为10~(3.00-9.50)copies/ml。结果:血清HBV-DNA在HBeAg阳性ASC病例最高,达10~(8.46±0.71)copies/ml,其次依次为HBeAg阳性CHB(10~(7.24±0.54) cooies/ml)、HBeAg阴性CHB(10~(6.04±0.69) copies/ml),HBeAg阴性ASC者最低,为10~(3.80±0.71)copies/ml。4组病例相互之间差异在统计学上均有显著意义(P<0.01)。28例BHeAg阳性CHB患者接受干扰素治疗,治疗结束时呈完全应答(CR)者13例,无应答(NR)15例。对13例CR患者继续随访6个月,其中4例血清ALT再升高(复燃)。血清HBV-DNA水平在治疗前,CR不伴ALT复燃组HBV-DNA为10~(3.44±0.43)copies/ml,明显低于CR伴ALT复燃组(10~(6.84±0.51))(P<0.01)和NR组(10~(7.18±0.66))(P<0.01)。结论:测定血清HBV-DNA水平有助于鉴别慢性HBV感染的不同状态;在HBeAg阳性CHB病例,干扰素治疗结束时,检测HBV-DNA水平对于判断疗效有指导价值,HBV-DNA低于104copies/ml往往能取得持久疗效。     

Suturing of the nasal septum after septoplasty, is it an effective alternative to nasal packing?

OBJECTIVE: To discuss and compare the results of suturing the nasal septum after septoplasty with the results of nasal packing. METHODS: A prospective study, which was performed at Prince Hashem Military Hospital in Zarqa, Jordan and Prince Rashed Military Hospital in Irbid, Jordan between September 2005 and August 2006 included 169 consecutive patients that underwent septoplasty. The patients were randomly divided into 2 groups. After completion of surgery, the nasal septum was sutured in the first group while nasal packing was performed in the second group. RESULTS: Thirteen patients (15.3%) in the first group and 11 patients (13%) in the second group had minor oozing in the first 24 hours, 4 patients (4.8%) had bleeding after removal of the pack in the second group. Four patients (4.8%) developed septal hematoma in the second group. Two patients (2.4%) had septal perforation in the second group. One patient (1.1%) in the first group, and 5 patients (5.9%) in the second group had postoperative adhesions. Five patients (5.9%) were found to have remnant deviated nasal septum in each group. The operating time was 4 minutes longer in the first group. CONCLUSION: Septal suturing after septoplasty offers the following advantages: elimination of discomfort for the patients, minimal complications, the outcome is almost the same as with nasal packing, and finally the hospital stay is less than with nasal packing. Therefore, suturing of the nasal septum after septoplasty should be a preferred alternative to nasal packing.     

核医学人体防护眼镜之现状及建议

报告了１５副核医学工作人员用的铅玻璃防护眼镜检测情况。建议改进：１．防护γ射线的效率要高，因此镜片厚度要有标准。２．可见光透过度要高。３．大的金属框架。４．改为额带式以解脱重负。