龙血竭胶囊治疗药物流产后异常子宫出血的研究

目的观察龙血竭胶囊用于治疗药物流产后异常子宫出血的临床效果并探讨其机理。方法将符合药物流产指征的160例早孕妇女随机分为两组,观察组服用龙血竭胶囊,对照组服用安慰剂,比较两组药物流产效果和出血量及出血时间;采用硝酸酶还原法、放射免疫法测定服药后血中一氧化氮(NO)、内皮素(ET-1)浓度。结果①观察组与对照组完全流产率无显著差异(P>0.05);②完全流产后出血量及平均出血时间观察组显著少于对照组(P<0.05);③血中NO浓度观察组显著低于对照组,而ET-1浓度观察组显著高于对照组(P<0.05)。结论药物流产时加服龙血竭胶囊可明显减少流产后出血量及时间。其作用机理可能是使血中的NO含量进一步降低,从而减弱NO舒张血管作用,增大子宫局部血流阻力,加速绒毛细胞的变性、坏死;减弱NO对血小板聚集的抑制作用,达到止血效果;增加血中ET-1的浓度,加强子宫血管的收缩,减少出血。     

广东汉族人肿瘤坏死因子A-308基因多态性

目的 了解广东汉族人肿瘤坏死因子A-308基因的分布特点。方法 应用聚合酶链反应技术对230例正常人肿瘤坏死因子A-308基因进行扩增,以NcoⅠ进行限制性内切酶酶切图谱分析,并结合文献进行了不同种族间的分析比较。结果 TNF-α 1／1、TNF-α1／2、TNF-α2／2表型频率分别为：0.8869、0.1087、0.0044,TNF-α1、TNF-α2基因频率分别为：0.9413、0.0587。结论 肿瘤坏死因子A-308基因多态性在不同种族间分布存在着明显的差异。     

妊娠高血压综合征与蛋氨酸合成酶还原酶（MSR）A66G基因多态与Hcy水平的关系

目的 探讨妊娠高血压综合征与蛋氨酸合成酶还原酶（MTRR）A66G基因及血浆同型半胱氨酸（Hcy）水平的关系．方法 运用多聚酶链反应-限制性内切酶片段长度多态性技术（PCR-RFLP）检测54例妊高征患者、100例正常妊娠妇女MSR A66G基因多态性，采用荧光偏振免疫法（FPI A）测定血浆总Hcy水平．结果 MSR A66G三种基因型频率与对照组相比差异无显著性．妊高征组总Hcy水平明显高于正常妊娠组（P〈0．05）．结论 MSR A66G基因突变与妊高征发生无关．     

Analysis of various etiologies of hypertension in patients hospitalized in the endocrinology division

This research aimed to analyze the clinical data of various etiologies of hypertension in patients hospitalized in the Endocrinology Division. The differences between essential and secondary hypertension were examined to provide a basis for clinical differential diagnosis. The data from all the inpatients with hypertension of unknown origin admitted in the Endocrinology Division of the First Affiliated Hospital of the Zhejiang University School of Medicine from January 2001 to May 2011 were reviewed. The patients were classified into either essential or secondary hypertensive groups. The differentiating parameters of these forms of hypertension were analyzed using the one-factor and multi-factor logistic regression analysis. A total of 1,001 cases were selected in which 346 cases (34.6%) were essential hypertensive and 655 cases (65.4%) were secondary hypertensive. Adrenal hypertension was the primary cause of secondary hypertension, followed by renal artery, central, psychogenic, and renal hypertension as well as others that have not been classified systematically. Using one-factor analysis, significant differences were found among duration of hypertension, age, the onset age, family history of hypertension, diastolic pressure on admission, Cushing syndrome, body mass index (BMI), urine protein, serum creatinine, orthostatic aldosterone, ratio of orthostatic aldosterone to renin activity, incidence of fatty liver displayed by type-B ultrasound, and computed tomography adrenal masses incidence (P < 0.05). Multi-factor regression analysis showed that family history of hypertension (OR = 7.196) and BMI above the normal range (OR = 15.124) were the independent factors that predicted essential hypertension, but failed to determine any other valid predictors of secondary causes except adrenal masses (OR = 10.114), orthostatic aldosterone value >200 pg/ml (OR = 9.742), and a ratio of orthostatic aldosterone and renin activity >40 (OR = 4.723).