Inhibitory effects of electrical stimulation on delivery in pregnant rats

Objective

To study the efficacy of uterine electrical stimulation (ES) with various parameters in delaying delivery in term- and preterm-laboring animals.

Study design

Catheters and electrodes, as well as ES electrodes, were sutured onto the uterine horn in day-15 pregnant rats. ES with various durations/frequencies (five sets of parameters) was tested from gestation day 21 to determine its effects on uterine contractility. The best set of ES parameters was applied in term (day 21) and preterm (day 18—labor induced) animals to determine the effects of ES on delivery.

Results

(1) Significant reduction in uterine contractions (0.54 ± 0.11 vs. 0.86 ± 0.08 contractions per minute, P < 0.001) was noted with ES of only one of the five sets of parameters (set #5 with pulse train of 10 s on and 10 s off, 28 ms pulse width, frequency of 30 Hz and amplitude of 4 mA); (2) ES with parameter set 5 delayed delivery by 12.5 h (P = 0.01) and reduced area under the curve of intrauterine pressure in mmHg s (311 ± 147.21 vs. 848.75 ± 350.38, P < 0.05) and AUC-electromyographic activity is area under rectified (i.e. absolute value) uterine EMG trace in mV s (145.25 ± 93.1 vs. 410 ± 182.46, P < 0.05) in the term rats; and (3) similar effects were noted with ES in preterm rats with a delay in delivery by 28 h (P < 0.001), and a decrease in IUP–AUC (intrauterine pressure–area under curve) (101.5 ± 55.45 vs. 551 ± 269.06, P = 0.017) and EMG–AUC (64.25 ± 43.63 vs. 172.5 ± 62.91, P = 0.03).

Conclusion

ES of the uterus with appropriate parameters inhibits uterine contractions and delays delivery in both term and preterm rats.     

Diurnal blood pressure variation in the evaluation of early onset severe pre-eclampsia

OBJECTIVE: To study the association between diurnal variation in blood pressure, the mean daily blood pressure and various complications of pregnancy in patients presenting with severe pre-eclampsia before 34 weeks' gestation. STUDY DESIGN: Forty-four women presenting to a tertiary hospital in South Africa with severe pre-eclampsia between 28 and 34 weeks' gestation were managed expectantly for at least 8 days. We measured maternal blood pressure every 30 min with the pregnancy validated Spacelabs 90209 automated blood pressure monitor for 24h periods on alternative days. The mean 24-h diastolic blood pressure measurement, the mean diastolic blood pressure for daytime and nighttime, the day-night blood pressure difference and the night-day ratio were compared with the occurrence of abruptio placentae, gestational age at delivery, neonatal intensive care unit admission, birth weight, abnormal umbilical artery Doppler FVW and reason for delivery. RESULTS: One hundred and seventy-six 24-h studies were analyzed. The day-night blood pressure difference decreased with increasing mean diastolic blood pressure (r=-0.323, p<0.0001). A combination of normal mean diastolic blood pressure and normal day-night blood pressure difference was associated with increased gestational age and lower caesarean section rates. CONCLUSION: The combination of mean diastolic blood pressure and day-night blood pressure difference may be a supplementary measurement of disease severity in early onset severe pre-eclampsia and seems to be of prognostic value.     

Pulmonary edema in man: Comparison of capillary filtration pressure, quantification by means of the double indicator-dilution method, and clinical observations

In three groups of patients, one with no signs of pulmonaryedema (n = 11), one with acute myocardial infarction but withoutpulmonary edema (n = 6) and one with recent myocardial infarctionand clinical signs of pulmonary edema (n = 13), investigationswere performed to determine the degree of pulmonary edema: Pulmonary capillary wedge pressure (PC W), plasma colloid osmoticpressure (COP), and critical pressure (CrP) defined as CrP =PCW – COP. The double indicator dilution method with ¹³¹/ albumin as anintravascular indicator and tritiated water (THO) as a diffusingindicator. Clinical estimates such as radiological and auscultatory criteria. Monitoring of PCW and plasma COP appears to give valuable informationon whether or not pulmonary edema fluid is being generated atthe moment when these measurements are being made. On the otherhand, the information obtained by the double indicator-dilutionmethod proved insufficient to warrant its adoption for routineclinical use. Even the difference in mean transit limes of thetwo indicators was found to be a better measurement of the degreeof pulmonary edema.     

沈阳市眼健康筛查人群眼压分布

目的：:分析沈阳地区30岁及以上眼健康筛查人群眼压的分布特征。方法：:横断面调查研究。收集2016年3—9月在沈阳市第四人民医院健康体检中心预约进行体检的30岁及以上的本地城市居民,按登记的居住地所属辖区分布,进行分层随机抽样。所有被纳入者在全身健康体检时增加生活视力、眼压和免散瞳眼底照相检查。眼压测量采用非接触眼压计...     

无创正压通气治疗COPD急性加重合并重度Ⅱ型呼吸衰竭的疗效观察

目的探讨无创正压通气(NPPV)治疗COPD急性加重(AECOPD)合并重度Ⅱ型呼吸衰竭的临床疗效。方法回顾分析2008年1月至2009年6月期间因AECOPD合并重度Ⅱ型呼吸衰竭住院接受NPPV治疗的37例患者(NPPV组),同期住院但未接受NPPV治疗的类似患者42例作为对照组。比较两组患者治疗前后的动脉血气、住院天数及治疗插管率。结果治疗后两者患者动脉血气pH、PaCO2、PaO2均较治疗前明显改善(P0.01,P0.05)。与对照组比较,NPPV组动脉血气pH、PaCO2、PaO2改善更明显(P0.05)。NPPV组的平均住院时间比对照组缩短[(10±5)d比(19±4)d,P0.05],气管插管率显著下降(2.7%比16.7%,P0.05)。结论对于AECOPD合并重度Ⅱ型呼吸衰竭患者,NPPV可以改善通气,缩短患者住院天数,降低气管插管率。     

平均动脉压对单肺通气患者动脉二氧化碳分压与呼气末二氧化碳分压差的影响

目的探讨胸科手术单肺通气（OLV）期不同平均动脉压（MAP）对动脉-呼气末二氧化碳分压差［（Pa-et）CO2］及对肺内分流
（Qs/Qt）的影响。方法42例行右肺叶部分切除术需OLV患者,按OLV 20 min后MAP在基础值±10%以内为A组（22例）,MAP
低于基础值30%为B组（20 例）。分别在诱导后双肺通气（TLV）20 min（T1）,OLV 20 min（T2）,B组复压后30 min（T3）,恢复
TLV20 min（T4）时点行血气分析,计算动脉-呼气末二氧化碳分压差［（Pa-et）CO2］及肺内分流（Qs/Qt）。结果A组患者的PetCO2
与PaCO2在OLV与TLV时均密切相关（P<0.05）;B组在T2时［（Pa-et）CO2］较A组增大,但PetCO2与PaCO2仍具有相关性（P<
0.05）;B组T2时期Qs/Qt高于A组（P<0.05）;在观察时间内,OLV期［（Pa-et）CO2］与（Qs/Qt）没有相关性（P>0.05）。结论OLV期
间血压正常时PetCO2可反映PaCO2的动态变化;低血压时［（Pa-et）CO2］增大,PetCO2与PaCO2相关性低于血压正常时,此时
PetCO2可能不能准确反映PaCO2的变化,需进一步行血气分析。
     

Wnt／β-catenin信号通路参与高渗条件下气道上皮细胞黏液高分泌

目的研究高渗刺激对人气道上皮细胞（16HBE）黏蛋白（MUC）5AC分泌的影响,以及Wnt／β-catenin信号通路可能的介导作用。方法使用浓氯化钠配置高渗培养液,用高渗培养液刺激16HBE细胞,细胞分为常规培养（阴性对照组）以及高渗培养液刺激3、6、9、12h组。ELISA法检测MUC5AC分泌量,Westernblotting法检测人气道Wnt家族蛋白Wnt1、Wnt2、Wnt3a、Wnt4、Wnt5a、Wnt7a、Wnt10a、Wnt10b的表达情况。将Wnt4小片段siRNA转染16HBE细胞,再给予高渗培养液刺激。采用ELISA法检测培养上清的MUC5AC分泌量,采用Westernblotting法检测细胞内经典Wnt／β-catenin通路相关信号分子的表达量,细胞免疫荧光法检测核因子（NF）-κBp65核转位情况。结果高渗培养的16HBE细胞上清及胞质中检测到的MUC5AC分泌量显著高于阴性对照组,且MUC5AC分泌量在一定范围内呈时间依赖性（均P〈0．05）。高渗刺激组Wnt1、Wnt2、Wnt3a、Wnt5a、wnt7a、Wnt10a和Wnt10b表达量较阴性对照组无明显变化（均P〉0．05）,而Wnt4表达量显著升高（P〈0．05）。高渗刺激组细胞内β-catenin和CyelinD1的相对表达量显著高于阴性对照组,细胞免疫荧光法提示NF-κBp65核转位（均P〈0．05）;而经转染Wnt4siRNA后,高渗培养组上清及胞质内MUC5AC分泌量显著低于未转染的高渗培养组（P〈0．05）,细胞内β-catenin、CyclinD1水平及NF-κBp65的核转位现象也受到显著抑制（均P〈0．05）。结论高渗盐水可诱导16HBE细胞MUC5AC高分泌,Wnt／β-catenin信号通路在该效应中有重要的参与作用。     

倍他洛尔滴眼液对兔急性高眼压模型视网膜神经节细胞的保护作用

目的：探讨倍他洛尔滴眼液对兔青光眼视网膜神经节细胞（RGC）的保护作用。方法：大耳白兔24只,随机分为对照组A和给药组B。两组内每只兔右眼作为对照组A1,B1组;左眼作高眼压灌注,各为A2,B2组。30 d后各组分别进行RGC凋亡检测,比较各组的差异。结果：A1与B1组没有找到染色阳性细胞。B2组比A2组染色阳性细胞少（P〈0.05）。结论：高眼压能导致RGC发生凋亡,而倍他洛尔滴眼液能部分地阻止其凋亡的发生,倍他洛尔滴眼液对RGC没有毒性作用。