Growing organs for transplantation from embryonic precursor tissues

Our recent data pinpoint a window of time in human and pig kidney organogenesis that may be optimal for transplantation into mature recipients. ‘Window’ transplants are defined by their remarkable ability to grow, differentiate and undergo vascularization, achieving successful organogenesis of urine-producing miniature kidneys. The transplanted tissue shows no evidence of trans-differentiation into non-renal cell types or tumorogenicity, and displays reduced immunogenicity compared to its adult counterparts. Very recently, we demonstrated that this approach can be extended to transplantation of embryonic pig liver, pancreas, and lung tissue. Furthermore, it was demonstrated that E42 pancreatic tissue is optimally suited for induction of normoglycemia in diabetic mice. These results emphasize the importance of selecting precursors of the correct gestational age for optimal growth and function, and with reduced immunogenicity, and provide a proof of principle for the curative potential of E42 embryonic pig pancreatic tissue for transplantation in diabetic patients. Deans Lecture Series, June 8, 2006 at South Florida Tampa Campus     

Is there any association between abdominal strength training before and during pregnancy and delivery outcome? The Norwegian Mother and Child Cohort Study

Background

Abdominal strength training before and during pregnancy has been recommended to enhance normal vaginal birth by enabling increased force needed for active pushing. However, to date there is little research addressing this hypothesis.

因胎儿异常引产孕妇产后抑郁的发生情况及其影响因素

目的描述因胎儿异常引产孕妇产后抑郁的发生状况并探讨其影响因素。方法采用便利抽样法,选取2016年1-10月湖南省某医院产科收治的因胎儿异常选择引产手术的114例孕妇为研究对象。采用自行编制的一般情况问卷、爱丁堡产后抑郁量表、社会支持评定量表、易感性人格类型量表等,调查胎儿异常引产孕妇产后抑郁、社会支持以及易感性人格类型得分情况,并分析其主要影响因素。结果胎儿异常引产孕妇爱丁堡产后抑郁量表总分(10.61±3.771)分,产后抑郁检出率为42.98%;居住地、文化水平、孕周、体质指数、社会支持利用度、组织性、表达性等7个因子进入产后抑郁的多元回归方程,共同解释总变异的54.4%(F=20.235,P0.001)。结论胎儿异常引产孕妇产后抑郁的发生率处于较高水平,个体的居住地、文化水平、孕周、体质指数、社会支持利用度、组织性及表达性是其产后抑郁的影响因素。医护人员应根据不同影响因素给予此类孕妇以针对性的护理指导,预防及减少产后抑郁的发生。     

宫颈注射利多卡因结合局部黏膜表面麻醉在妊娠终止术中的应用

目的探讨利多卡因在妊娠终止术中的临床价值。方法选择2009年1月至12月,妊娠时间<10孕周,在湖北省孝感市中心医院行妊娠终止术患者328例为研究对象。将其随机分为观察组(使用宫颈注射利多卡因+宫颈口黏膜表面麻醉,n=164)和对照组(常规手术,n=164)。两组患者年龄、孕龄、孕次、产次及体重等比较,差异无显著意义(P>0.05)。观察两组患者宫颈松弛程度、术中疼痛、出血量等(本研究遵循的程序符合湖北孝感市中心医院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果观察组和对照组患者宫颈松弛程度总有效率分别为87.20%和18.90%,两组比较,差异有显著意义(P<0.01)。观察组和对照组术中镇痛总有效率分别为80.49%和16.46%,两组比较,差异有显著意义(P<0.01)。结论宫颈注射利多卡因+宫颈口黏膜表面麻醉用于妊娠终止术,可减轻患者痛苦,预防妊娠终止术综合征,效果满意且价格低廉,操作简便,易于推广。     

棉酚合并卡前列甲酯(PG05)抗早孕作用研究

观察棉酚合并 PG0 5对小鼠的抗早孕作用。结果显示 :单用棉酚 75mg/( kg·d) ,3d无抗早孕作用 ,而同样剂量棉酚与 PG0 50 .2 mg/( kg·d) ,合用 2 d可显著增强抗早孕作用 ,使小鼠活胎数进一步减少 ;棉酚 30 μg/ml和 ( - )棉酚 1 5μg/ml对大鼠黄体细胞 3β- HSD活性均有显著抑制作用 ,( + )棉酚 1 5μg/ml和PG0 51 0 μg/ml对此酶活性无影响 ;( - )棉酚 1 5μg/ml还能抑制大鼠颗粒细胞雌二醇的分泌 ,提示棉酚增强 PG0 5抗早孕作用可能是从多环节影响胚胎正常发育。     

妊娠伴发霍乱36例临床分析

目的 提高妊娠伴发霍乱的治疗水平。方法 报告了1997年11月～1998年1月桑给巴尔暴发的一次霍乱大流行,其中36例妊娠妇女伴发霍乱者被收住院治疗。轻型14例,重型22例。所有病例粪便常规检查霍乱弧菌均阳性。在补液、补充电解质,调节酸碱干衡紊乱的同时,积极处理死胎及流产病例。对孕周>35周者,当孕妇腹泻减轻、休克纠正、病情好转后,不论胎儿是否存活,均应迅速终止妊娠。结果 14例轻型霍乱的孕妇痊愈出院,22例重型霍乱的孕妇中痊愈出院11例,死亡11例,其中4例死于肾功能衰竭,4例死于胎盘滞留、胎盘残留所致的产后大出血,3例死于心肺功能衰竭。36例胎儿中,死胎伴流产22例,死产3例,活产6例,5例维持正常妊娠,随母亲出院。结论 妊娠伴发霍乱是一种起病急、病情变化快、严重威胁母儿生命的烈性传染病,治疗上除快速大量补液外,迅速安全地终止妊娠也是治疗的关键。     

Initiation of Ventricular Tachycardia by Interruption of Pacemaker-Mediated Tachycardia in a Patient with a Dual-Chamber Implantable Cardioverter Defibrillator

A 74-year-old man with a dual-chamber implantable cardioverter defibrillator implanted 3 years before experienced multiple ventricular tachycardias (VTs). All episodes were initiated by pacemaker-mediated tachycardia (PMT) that was either stopped by atrial undersensing or the tachycardia termination algorithm of the device. After the termination of PMT, two rapid ventricular paced beats, the first initiated by artificial triggering and the second due to retrograde conduction of the first one, initiated VT that was successfully terminated by antitachycardia pacing or a direct current shock of the device . All episodes revealed this pattern of initiation with a short-long-short ventricular sequence inducing VT.     

Prolactinoma and pregnancy: From the wish of conception to lactation

Prolactinoma is a common cause of infertility in young women and treatment with dopamine agonists (DA) allows restoration of fertility in over 90% of the cases. Both bromocriptine and cabergoline have shown a good safety profile when administered during early pregnancy. In particular, data on exposure of the fetus or embryo to cabergoline during the first weeks of pregnancy have now been reported in more than 900 cases, and do indicate that cabergoline is safe in this context. There is no increase in the frequency of spontaneous miscarriage, premature delivery, multiple births or neonatal malformations, and follow-up studies of the children for up to 12 years after fetal exposure to cabergoline did not show any physical or developmental abnormalities. These women should therefore continue DA treatment until pregnancy has been initiated. Treatment discontinuation is recommended at that time in women with microprolactinoma or non-compressive macroprolactinoma. For microprolactinomas, the risk of symptomatic tumour enlargement during pregnancy is very low (2–3%). It is higher for macroprolactinomas (20–30%) and careful follow-up is advised, including MRI without contrast injection if symptoms or visual disturbances develop. If a symptomatic tumour enlargement does occur, reinitiation of the dopamine agonist (BRC or CAB) is indicated rather than surgery. Breast-feeding has no harmful effect on tumour growth and DA treatment, if still needed, may be postponed as long as breast-feeding is desired. Finally, about 40% of women with a microprolactinoma or an intermediate size macroprolactinoma may be in prolonged remission after one or more pregnancies.     

Arthrogryposis associated with unsuccessful attempts at termination of pregnancy

We report three cases of failed termination of pregnancy in which the children were subsequently born with arthrogryposis (AMC) (multiple congenital contractures). Arthrogryposis is a sign with many causes. We suggest that the multiple congenital contractures seen in these children are due to vascular compromise during the attempted termination with secondary loss of functional neurons leading to fetal akinesia and subsequent contractures. Two of the children have additional evidence of intrauterine vascular compromise. Limitation of movement secondary to the rupture of the fetal membranes and continuous leakage of amniotic fluid after the attempted termination may have compounded the contractures in two of the children. © 1996 Wiley-Liss, Inc.     

超声估测先兆流产预后的评价

目的：在超声指导下提高先兆流产的保胎成功率。方法：对先兆流产的不同超声图像进行研究,分类比较,并进行统计学分析。结果：妊囊规则,胎膜下出血面积小和（或）有正常卵黄囊的,预后较好。结论：运用超声估测先兆流产预后,方法安全简便,可将临床治愈率提高到90％以上。