Cook水囊在瘢痕子宫中期妊娠引产中的临床应用研究

目的探讨米索前列醇联合Cook水囊在瘢痕子宫中期妊娠引产中的应用价值。方法选择新疆医科大学第一附属医院计划生育病区剖宫产术后再孕、要求引产的患者50例。随机分为两组,对照组采用传统利凡诺引产,观察组采用米索前列醇联合Cook水囊引产。比较两组从规律宫缩至胎儿娩出时间、引产成功率、产后出血量、胎盘胎膜残留率及产道损伤情况。结果 (1)对照组从规律宫缩至胎儿娩出时间为(14.6±3.26)h,观察组从规律宫缩至胎儿娩出时间为(7.3±2.56)h,两组相比差异有统计学意义(P<0.05)。(2)对照组引产成功率为92%,观察组引产成功率为100%,两组相比差异无统计学意义(P>0.05)。(3)对照组产后24h出血量为(214±103)mL,观察组产后24h出血量为(156±98)mL,两组相比差异有统计学意义(P<0.05)。(4)对照组患者胎盘胎膜残留率为44%,引产成功者中有2例宫颈轻度裂伤。观察组胎盘胎膜残留率为24%,与对照组相比,观察组完全流产率高,清宫率低,引产并发症少,两组相比差异有统计学意义(P<0.05)。结论对于瘢痕子宫中期妊娠的患者,在米非司酮软化宫颈的基础上,联合米索前列醇和Cook水囊比单用依沙吖啶效果好,特别对于宫颈条件差、内口紧的患者,效果更佳。有引产成功率高、产后出血少、并发症少的优点。     

卵巢过度刺激综合征发病机制的研究进展

卵巢过度刺激综合征(OHSS)是促排卵过程中严重的医源性并发症,人绒毛膜促性腺激素诱导排卵使过多卵泡受刺激有关。其发病机制不明,病理生理特征主要为毛细血管通透性增加以及富含蛋白的液体停留在血管外间隙,导致血液浓缩,第三间隙水肿。现从血管内皮生长因子、血小板活化因子、溶血磷脂酸诱导炎性因子、囊性纤维化跨膜传导调节因子、肾素-血管紧张素系统对OHSS发病机制进行探讨分析,为临床更好地治疗和预防OHSS的发生提供理论依据。     

Identification of seven novel SMPD1 mutations causing Niemann–Pick disease types A and B

Niemann–Pick disease (NPD) types A and B are autosomal, recessively inherited, lysosomal storage disorders caused by deficient activity of acid sphingomyelinase (E.C. 3.1.4.12) because of mutations in the sphingomyelin phosphodiesterase‐1 (SMPD1) gene. Here, we present the molecular analysis and clinical characteristics of 15 NPD type A and B patients. Sequencing the SMDP1 gene revealed eight previously described mutations and seven novel mutations including four missense [c.682T>C (p.Cys228Arg), c.1159T>C (p.Cys387Arg), c.1474G>A (p.Gly492Ser), and c.1795C>T (p.Leu599Phe)], one frameshift [c.169delG (p.Ala57Leufs*20)] and two splicing (c.316+1G>T and c.1341delG). The most frequent mutations were p.Arg610del (21%) and p.Gly247Ser (12%). Two patients homozygous for p.Arg610del and initially classified as phenotype B showed different clinical manifestations. Patients homozygous for p.Leu599Phe had phenotype B, and those homozygous for c.1341delG or c.316+1G>T presented phenotype A. The present results provide new insight into genotype/phenotype correlations in NPD and emphasize the difficulty of classifying patients into types A and B, supporting the idea of a continuum between these two classic phenotypes.     

Methods for Examination an Explanted Coronary Sinus Lead Stabilized with a Coronary Stent

The aim of our investigation was to test the suitability of a novel method for the analysis of the integrity of an explanted pacemaker lead stabilized by a stent. A coronary sinus lead has been explanted 27 months after implantation and has been examined by optical‐, confocal‐, x‐ray‐, and scanning electron microscopy. Several surface injuries were found on the insulation. Based on the surface characteristics, it is possible to define and differentiate the source of damages as well as to measure the extent of injuries. Impedance of the explanted lead has also been measured and electronic integrity has been verified. (PACE 2013; 36:e27–e30)     

头痛宁治疗偏头痛效果及安全性的Meta分析

目的 评价头痛宁胶囊治疗偏头痛的临床效果.方法 计算机检索维普、中国生物医学文献数据库、中国知网、万方数据库进行资料收集,筛选2001年1月1日～2014年6月1日间所有使用头痛宁与西药治疗偏头痛的随机对照试验(RCT),同时手动检测其参考文献.采用Jadad7分评分法评价纳入文献质量,由2名评价者独立进行文献质量评价和资料提取后,采用RevMan 5.0软件进行Meta分析.结果 检出符合标准RCT文献共144篇,筛选出10项研究(中药组602例,西药组566例)进行Meta分析.头痛宁治疗偏头痛效果与西药比较,其总OR=1.19,95％CI为(1.12,1.27);在治愈率方面,OR=1.61,其95％CI为(1.24,2.09);在安全性方面,其不良反应出现OR=1.64,95％CI为(0.29,0.90).结论 头痛宁治疗偏头痛效果确切,比西药单纯治疗效果好,两者合用可能取得更好的效果,但尚需更多高质量的研究以增加证据的强度.     

唐山地区野生药用植物资源开发利用价值评价初步研究简

目的：评价唐山地区的野生药用植物资源的开发利用价值,为药用植物资源的综合开发利用提供依据。方法：在药用植物资源调查的基础上,采用系统工程论中的层次分析法定量评价唐山地区野生药用植物资源的开发利用价值,筛选出可供开发利用的药用植物资源。结果：初步调查及评价结果显示唐山地区可供开发利用的药用植物资源有62种。结论：唐山地区可供开发利用的野生药用植物资源丰富,应制定综合开发利用及保护规划,综合开发利用各药用植物资源,并保持生态资源的可持续发展。     

Induction of bone formation in biphasic calcium phosphate scaffolds by bone morphogenetic protein‐2 and primary osteoblasts

Bone tissue engineering strategies mainly depend on porous scaffold materials. In this study, novel biphasic calcium phosphate (BCP) matrices were generated by 3D‐printing. High porosity was achieved by starch consolidation. This study aimed to characterise the porous BCP‐scaffold properties and interactions of osteogenic cells and growth factors under in vivo conditions. Five differently treated constructs were implanted subcutaneously in syngeneic rats: plain BCP constructs (group A), constructs pre‐treated with BMP‐2 (group B; 1.6 µg BMP‐2 per scaffold), seeded with primary osteoblasts (OB) (group C), seeded with OB and BMP‐2 (group D) and constructs seeded with OB and pre‐cultivated in a flow bioreactor for 6 weeks (group E). After 2, 4 and 6 weeks, specimens were explanted and subjected to histological and molecular biological analyses. Explanted scaffolds were invaded by fibrovascular tissue without significant foreign body reactions. Morphometric analysis demonstrated significantly increased bone formation in samples from group D (OB + BMP‐2) compared to all other groups. Samples from groups B‐E displayed significant mRNA expression of bone‐specific genes after 6 weeks. Pre‐cultivation in the flow bioreactor (group E) induced bone formation comparable with group B. In this study, differences in bone distribution between samples with BMP‐2 or osteoblasts could be observed. In conclusion, combination of osteoblasts and BMP‐2 synergistically enhanced bone formation in novel ceramic scaffolds. These results provide the basis for further experiments in orthotopic defect models with a focus on future applications in orthopaedic and reconstructive surgery. Copyright © 2012 John Wiley & Sons, Ltd.