稽留流产孕早期预测模型的构建与验证

目的构建稽留流产(missed abortion,MA)患者在孕早期流产危险因素列线图。方法纳入2017年2月至2019年10月因稽留流产于中国建筑第二工程局职工医院治疗的孕妇125例为研究组,随机纳入同时期正常孕妇126例为对照组,分析两组患者临床基本资料:年龄、环境因素、动物接触史、叶酸使用、文化程度、流产情况、疾病史、激素水平等。采用Logistic回归分析对孕早期发生稽留流产的危险因素进行分析,应用R软件建立孕早期稽留流产预测列线图,并进行验证。结果研究组孕妇年龄、睾酮(testosterone,T)水平高于对照组,而催乳素(prolactin,PRL)、雌二醇(estradiol,E2)、孕酮(progesterone,P)水平低于对照组,差异均有统计学意义(P<0.05);Logistic回归分析提示孕妇年龄(OR=1.809,P=0.003)、吸烟饮酒(OR=78.120、P=0.044)、职业暴露(OR=61.238,P=0.021)、T水平(OR=5.432,P=0.001)是孕早期发生MA的危险因素。PRL(OR=0.376,P=0.003)、E2(OR=0.258,P=0.016)、P(OR=0.396,P=0.005)是孕早期发生MA的保护因素。预测孕早期MA发生的相关危险因素的C-index为0.912(95%CI:0.874-0.943)。结论列线图中孕妇年龄、环境因素、激素水平能较准确的预测孕早期发生MA的风险。     

miR-200、 miR -155及血管新生因子与复发性流产的相关性分析

目的 研究miR-200、miR-155及血管新生因子与原因不明复发性流产(unexplained recurrent spontaneousabortion,URSA)的相关性分析。 方法 选择2015年3月—2018年1月在青岛市妇女儿童医院妇产科就诊的URSA患者作为URSA组、要求终止妊娠的正常早孕患者作为对照组,检测绒毛组织中微小RNA(microRNA, miR)miR-200、miR-155、血管内皮生长因子(vascular endothelial growth factor,VEGF)、可溶性FMS样酪氨酸激酶1(soluble FMS like tyrosine kinase-1,sFlt-1)的表达量及血清中VEGF、sFlt-1的含量,对miR-200、miR-155靶向结合VEGF、sFlt-1进行生物信息学分析。 结果 URSA组的绒毛组织中miR-200(1.78±0.32 vs. 0.91±0.15)、sFlt-1(1.87±0.35 vs. 1.06±0.21)的相对表达量及血清中sFlt-1的含量[(12.39±2.31)ng/ml vs. (6.51±0.95)ng/ml]均高于对照组,差异有统计学意义(均P<0.05)。绒毛组织中miR-155相对表达量(0.60±0.10 vs. 0.93±0.16)、VEGF mRNA相对表达量(0.59±0.09 vs. 1.02±0.16)及蛋白表达量(0.62±0.07 vs. 1.04±0.18)、血清中VEGF的含量[(601.25±94.39)ng/ml vs. (935.12±132.47)ng/ml]低于对照组,差异有统计学意义(均P<0.05);URSA组患者绒毛组织中miR-200的表达量与血清中VEGF的含量、绒毛组织中VEGF的表达量均呈负相关,绒毛组织中miR-155的表达量与血清中sFlt-1的含量和绒毛组织中sFlt-1的表达量均呈负相关;miR-200、miR-155分别靶向结合VEGF、sFlt-1基因的3’UTR。 结论 miR-200表达增多、miR-155表达减少与URSA发生有关,miR-200靶向VEGF、miR-155靶向sFlt-1是介导该过程的可能机制。     

Spontaneous recovery of fear differs among early – late adolescent and adult male mice

Adolescence is a vulnerable period for developing anxiety-related mental disorders such as post-traumatic stress disorder (PTSD), which requires a long-term course of therapy when a traumatic event has been experienced during childhood. However, the biological mechanism underlying these age-dependent characteristics remains unclear. In the present study, we used early adolescent, late adolescent and adult (4-, 8-, and 15-week old) male mice to examine age differences in fear memory, fear extinction, and spontaneous recovery of fear. We also measured the activation of extracellular signal-regulated kinase (ERK) 2 in the dorsal hippocampus (dHip) and the basolateral amygdala (BLA) following a spontaneous recovery test. Our major findings were as follows: (1) early adolescent and adult mice did not recover the fear response; only late adolescent mice recovered the fear response. (2) The ERK2 in the dHip was more activated after the spontaneous recovery test in late adolescent mice than in adult mice, and the ERK2 in the BLA was more activated after the spontaneous recovery test in adult mice than in late adolescent mice. These results suggest that there exists a unique period in which spontaneous recovery occurs and that these late adolescent behavioral signatures may be related to alteration in the ERK2 phosphorylation in the dHip and BLA.     

自发性高血压大鼠颈动脉血管平滑肌中抑癌基因P53和原癌基因c-jun、c-fos、c-myc mRNA表达的研究

目的探讨自发性高血压大鼠颈动脉中抑癌基因P53和原癌基因c-jun、c-fos、c-myc mRNA的表达.方法用逆转录聚合酶链式反应检测两种基因的表达水平.正常雄性大鼠作为对照组.结果 SHR颈动脉中,抑癌基因P53和原癌基因c-jun、c-fos、c-myc均有高表达,较WKY差异有显著性(P<0.05).结论自发性高血压大鼠颈动脉组织中抑癌基因P53和原癌基因c-jun、c-fos、c-myc均有高表达,癌基因的活化可能与自发性高血压大鼠颈动脉血管重构有关.     

米非司酮配伍卡前列甲酯89例与米非司酮配伍米索前列醇110例终止早期妊娠的比较

目的：比较米非司酮配伍卡前列甲酯与米非司酮配伍米索前列醇终止早期妊娠的疗效。方法：妊娠≤４９ｄ孕妇１９９例，年龄２６±５ａ，随机分Ａ组８９例，Ｂ组１１０例。２组均用米非司酮２５ｍｇ，ｂｉｄ，３ｄ，于ｄ４，Ａ组阴道后穹窿置卡前列甲酯栓１ｍｇ。Ｂ组米索前列醇ｐｏ，６００μｇ。结果：Ａ和Ｂ组完全流产率各为８３％和９３．６％，经Ｘ２检验，Ｐ＜０．０５；胎囊排出时间，Ａ组４±５ｈ，Ｂ组３±６ｈ，２组无显著差异。结论：米非司酮配伍米索前列醇的抗早孕效果优于配伍卡前列甲酯。     

自发性食管破裂的诊断和外科治疗

目的:探讨自发性食管破裂的诊断和外科治疗。方法 :对 14例自发性食管破裂患者的诊断、治疗方法及治疗结果进行回顾性分析。结果:本组确诊时间 2 4 h以内者仅 2例 ,确诊时间大于 2 4 h者 12例 ;一期食管修补、带蒂胸膜覆盖术 3例 ,治愈 1例 ,治疗失败 2例 (其中 1例死亡 ,1例延期行结肠代食管术后治愈 ) ;行破裂段食管切除、胃 -食管吻合术的 5例全部治愈 ;保守治疗 6例 ,治愈及死亡各 3例。结论:早期诊断自发性食管破裂是提高疗效、降低病死率的关键。发病 2 4 h以上者 ,如全身情况允许 ,破裂段食管切除、胃 -食管吻合术的疗效较好。     

Behavioral models in mice. implication of the alpha noradrenergic system

1. The mechanism of action of drugs might change according to the test used. Several noradrenergic drugs were tested in order to understand their implication in the mobility tests.

2. It was found that clonidine, an Alpha 2 agonist, acted differently according to the tast used. It provoked sedation in spontaneous activity test, and anti-immobility effects in the other tests.

3. Tall suspension test is able to show the double acting of clonidine.

4. Idazoxan might act either as an alpha 2 antagonist or as partial alpha 2 agonist. TST shown the unexpected partial alpha agonist effect of the molecule.

5. Forced swimming test is more specific for predicting antidepressant activity than tail suspension test which is close to a spontaneous activity model.     

Treatment Outcomes in Spontaneous Intracranial Hypotension: Do Epidural Blood Patches Stop the Leaks?

Abstract:   Spontaneous intracranial hypotension (SIH) is a postural headache syndrome unrelated to dural puncture. Because of the increasing failure of epidural blood patch (EBP) to relieve headache in SIH, we retrospectively investigated the epidemiological features and treatment outcomes in 55 cases of SIH. The study population was stratified by age and sex; continuous variables were compared for differences by t -tests; categorical variables were compared by Chi-squared analysis or Fisher exact tests. Significant differences were identified by P values of 0.05 or less. The mean age of the study population was 44 ± 12 years with a female to male ratio of 1.3:1.0. Men presented with subdural hematomas ( P  = 0.001) more often than women. Meningeal enhancement on contrast magnetic resonance imaging (MRI) was the most consistent radiographic finding. Radionuclide cisternography (RC) demonstrated thoracolumbar dural leaks in 16 of 22 patients. EBP failures were more common in patients aged 40 and younger than in older patients ( P  = 0.003). Postural headache from SIH was not uniformly responsive to EBP, and had significant comorbidities, especially in men. The management of postural headache in SIH by other techniques to restore brain position and cerebrospinal fluid dynamics should be investigated.