剖宫产瘢痕妊娠39例临床诊疗分析

目的:总结剖宫产瘢痕妊娠(CSP)的临床特点,探讨CSP的早期正确诊断方法及恰当的治疗方法。方法:回顾性分析2002年1月至2009年2月我院收治的39例剖宫产瘢痕妊娠患者临床资料及临床诊疗经过。结果:患者的平均年龄是31.5±5.0岁,均有子宫下段剖宫产史。患者均有停经史,26例发生停经后阴道点滴到中度流血。28例误诊为正常早孕或难免流产而行人流或药流,2例阴道大出血急行剖腹探查术,术后病理确诊,其余患者由彩色超声多普勒确诊,依据血β-HCG值高低分组采用米非司酮加甲氨蝶呤全身和/或局部应用的个体化治疗,两例另行子宫动脉栓塞术。患者均痊愈出院,随诊血β-HCG值至正常。结论:剖宫产术后子宫瘢痕妊娠临床表现缺乏特异性,容易误诊,应当加强对本病的认识,结合病史、查体及辅助检查以期早期诊断,可根据患者血β-HCG值选取不同的治疗方案。     

小鼠诱导性多能干细胞移植治疗宫内缺氧新生鼠脑损伤

目的:研究小鼠诱导性多能干细胞(iPSCs)移植对宫内缺氧新生鼠脑损伤的治疗作用及机制。方法:于孕14 d开始孕鼠置于动物缺氧培养箱中,制作胎鼠宫内缺氧模型。孕鼠分娩后新生鼠经侧脑室注入BrdU标记的iPSCs悬液移植组和PBS缺氧组,对照组不治疗,H-E染色观察脑组织形态学变化、八臂迷宫测试动物记忆功能、免疫组织化学检测脑BrdU阳性细胞和神经颗粒素(Ng)和神经元烯醇化酶(NSE)的表达、原位杂交检测血管内皮生长因子mRNA(VEGF mRNA)的表达。结果:移植组小鼠的学习记忆能力和脑皮质区细胞结构较缺氧组均明显改善;脑切片检出BrdU阳性细胞存在,缺氧组Ng和NSE阳性细胞表达较对照组显著减少,而VEGF mRNA的表达较对照组显著增加;移植组Ng、NSE和VEGF mRNA表达均较缺氧组显著增加。结论:小鼠iPSCs移植于宫内缺氧的新生小鼠脑中,可减轻缺氧神经元的损伤和提高学习能力,其机制可能通过上调VEGF mRNA和Ng的表达有关。     

Candida in dermatology

Regarding Candida in dermatology, two pathogenetic pathways must be taken into account: 1. on infection of the skin 2. immunological reactions with skin alterations as a result of Candida infection or colonization in the mouth and/or intestine. Case reports describe typical situations of napkin dermatitis, intertriginous candidosis, the intrauterine Candida infection of the foetus, Candida granuloma, Candida folliculitis and Candida paronychia. In the second part results of investigations of patients suffering from psoriasis, atopic dermatitis and urticaria are presented. There were no differences in the colonization with Candida albicans and in the level of Candida antibody titres between patients and a healthy control group.     

三七总皂苷改善宫内缺氧新生鼠脑损伤及学习记忆功能

目的:制作胎鼠宫内缺氧模型,探讨三七总皂苷对宫内缺氧新生大鼠突触重建及学习记忆功能的影响。方法:孕14 d开始将孕鼠置于动物缺氧培养箱中,制作胎鼠宫内缺氧模型。新生鼠经腹腔分别注入三七总皂苷和生理盐水;正常对照组不治疗。免疫荧光法检测脑微管相关蛋白-2(MAP-2)、胶质纤维酸性蛋白(GFAP)、突触素(SYN)和突触分化诱导基因1(SynDIG1)的表达。Morris水迷宫实验检测各组大鼠的学习记忆功能。结果:Morris水迷宫结果表明,与对照组相比,模型组大鼠学习记忆能力明显下降,经三七总皂苷治疗后学习记忆能力明显改善。缺氧后新生鼠脑MAP-2、SYN和SynDIG1表达明显减少,GFAP表达明显增多;治疗组MAP-2、SYN、SynDIG1表达明显高于模型组,GFAP表达明显低于模型组。结论:三七总皂苷可减轻缺氧缺血后神经元的损伤,减弱GFAP的表达,促进突触的重建,改善宫内缺氧大鼠学习记忆功能。     

Preeclampsia is an independent risk factor for spontaneous intestinal perforation in very preterm infants

Abstract

Background: Spontaneous intestinal perforation (SIP) is an important surgical emergency in preterm infants.

Aims: To evaluate the effect of maternal preeclampsia on development of SIP in premature infants.

Study design: Retrospective observational study in a large tertiary neonatal intensive care unit.

Subjects: The preterm infants of ≤32 weeks of gestational age and birthweight ≤1500?g who were hospitalized were enrolled.

Outcome measures: The primary outcome was to determine the association between preeclampsia and SIP.

Results: A total of 22 infants had SIP diagnosis. The incidence of SIP in infants born to preeclamptic mothers (6.2%) was significantly higher compared with those born to normotensive mothers (0.2%). In multinominal logistic regression model, preeclampsia was found to be an independent risk factor of SIP with an odds ratio of 13.5 (95% confidence interval 2.82–65.1).

Conclusions: Maternal preeclampsia seemed to be an independent risk factor for development of SIP in premature infants.