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Objective: To identify the risk factors related to perinatal complications in patients with pulmonary hypertension underwent cesarean section. Methods: We retrospectively analyzed the medical records of all pregnant women with pulmonary hypertension hospitalized in 4 different hospitals in Shandong province and underwent cesarean section between May 2010 and May 2020. Patients were divided into perinatal complication group and control group according to the presence or absence of perinatal complications. Perinatal complications included aggravated heart function, new onset arrythmias, sudden cardiac arrest, all-cause death within 42 days post cesarean section, postpartum bleeding and thrombotic events. Risk factors of perinatal complications were analyzed. Results: A total of 167 patients (47 cases in the perinatal complication group and 120 cases in the control group) were included in this study. The average age of this cohort was 28(24, 32) years, and 75(44.9%) patients suffered newly diagnosed pulmonary hypertension during pregnancy. The main cause of pulmonary hypertension was congenital heart disease (137(82.0%)). Age, pregnant weeks, percent of primipara, intra-cardiac shunt, and receiving targeted medication therapy, cardiac dimensions were similar between the two groups. A total of 62 complications were recorded in the complication group including 28 cases of aggravated heart function, 4 cases of new onset arrythmias, 2 cases of cardiac arrest, 11 cases of bleeding or thrombotic events and 17 patients were dead. Prevalence of idiopathic pulmonary hypertension and general anesthesia was significantly higher, functional capacity was significantly lower in perinatal complication group than in control group (all P<0.05). The estimated systolic pulmonary artery pressure, serum N-terminal pro-B type natriuretic peptide and total bilirubin (TBIL) levels were significantly higher in perinatal complication group than in control group (all P<0.05). Logistic analysis demonstrated WHO Function Class(FC) Ⅲ/Ⅳ (OR=2.416,95%CI 1.016-5.743, P=0.046) and TBIL level (OR=6.874,95%CI 1.643-28.757, P=0.008) were the independent risk factors of perinatal complications. Conclusion: TBIL and WHO FC are independent risk factors of perinatal complications in pregnant women with pulmonary hypertension underwent cesarean section.
الموضوعات
Female , Humans , Pregnancy , Cesarean Section/adverse effects , China/epidemiology , Hypertension, Pulmonary/epidemiology , Pregnancy Outcome , Retrospective Studies , Risk Factorsالملخص
OBJECTIVE@#To observe the clinical curative effect on attention deficit hyperactivity disorder (ADHD) and explore the relevant mechanism of acupuncture in treatment.@*METHODS@#A total of 100 ADHD children were randomized into an observation group (50 cases, 2 cases dropped off) and a control group (50 cases, 1 case dropped off). In the control group, the routine psychological intervention was used. In the observation group, on the base of the treatment as the control group, acupuncture was applied to Taichong (LR 3), Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6), Baihui (GV 20), Sishencong (EX-HN 1), etc., once daily, for 3 months. The Cambridge neuropsychological tests automated battery (CANTAB) was adopted to evaluate attention and response inhibition in two groups before and after treatment. Digi-Lite color transcranial Doppler was used to measure cerebral arterial blood velocity. The therapeutic effect was compared between the two groups.@*RESULTS@#Regarding evaluation of attention, the mean delay time in the observation group after treatment was shorter than that before treatment and that in the control group separately (@*CONCLUSION@#Acupuncture combined with psychological intervention may improve attention and response inhibition in ADHD children, which is possibly related to the regulation of cerebral blood flow.
الموضوعات
Child , Humans , Acupuncture Points , Acupuncture Therapy , Attention Deficit Disorder with Hyperactivity/therapy , Cerebrovascular Circulation , Psychosocial Interventionالملخص
Objective: Transanal total mesorectal excision (taTME) was a very hot topic in the first few years since its appearance, but now more introspections and controversies on this procedure have emerged. One of the reasons why the Norwegian Ministry of Health stopped taTME was the high incidence of postoperative anastomotic leak. In current study, the incidence and risk factors of anastomotic leak after taTME were analyzed based on the data registered in the Chinese taTME Registry Collaborative (CTRC). Methods: A case-control study was carried out. Between November 15, 2017 and December 31, 2020, clinical data of 1668 patients undergoing taTME procedure registered in the CTRC database from 43 domestic centers were collected retrospectively. After excluding 98 cases without anastomosis and 109 cases without complete postoperative complication data, 1461 patients were finally enrolled for analysis. There were 1036 males (70.9%) and 425 females (29.1%) with mean age of (58.2±15.6) years and mean body mass index of (23.6±3.8) kg/m(2). Anastomotic leak was diagnosed and classified according to the International Study Group of Rectal Cancer (ISREC) criteria. The risk factors associated with postoperative anastomotic leak cases were analyzed. The impact of the cumulative number of taTME surgeries in a single center on the incidence of anastomotic leak was evaluated. As for those centers with the number of taTME surgery ≥ 40 cases, incidence of anastomic leak between 20 cases of taTME surgery in the early and later phases was compared. Results: Of 1461 patients undergoing taTME, 103(7.0%) developed anastomotic leak, including 71 (68.9%) males and 32 (31.1%) females with mean age of (59.0±13.9) years and mean body mass index of (24.5±5.7) kg/m(2). The mean distance between anastomosis site and anal verge was (2.6±1.4) cm. Thirty-nine cases (37.9%) were classified as ISREC grade A, 30 cases (29.1%) as grade B and 34 cases (33.0%) as grade C. Anastomotic leak occurred in 89 cases (7.0%,89/1263) in the laparoscopic taTME group and 14 cases (7.1%, 14/198) in the pure taTME group. Multivariate analysis showed that hand-sewn anastomosis (P=0.004) and the absence of defunctioning stoma (P=0.013) were independently associated with anastomotic leak after taTME. In the 16 centers (37.2%) which performed ≥ 30 taTME surgeries with cumulative number of 1317 taTME surgeries, 86 cases developed anastomotic leak (6.5%, 86/1317). And in the 27 centers which performed less than 30 taTME surgeries with cumulative number of 144 taTME surgeries, 17 cases developed anastomotic leak (11.8%, 17/144). There was significant difference between two kinds of center (χ(2)=5.513, P=0.019). Thirteen centers performed ≥ 40 taTME surgeries. In the early phase (the first 20 cases in each center), 29 cases (11.2%, 29/260) developed anastomotic leak, and in the later phase, 12 cases (4.6%, 12/260) developed anastomotic leak. The difference between the early phase and the later phase was statistically significant (χ(2)=7.652, P=0.006). Conclusion: The incidence of anastomotic leak after taTME may be reduced by using stapler and defunctioning stoma, or by accumulating experience.
الموضوعات
Adult , Aged , Female , Humans , Male , Middle Aged , Anastomotic Leak/etiology , Case-Control Studies , China/epidemiology , Incidence , Laparoscopy , Postoperative Complications/epidemiology , Rectal Neoplasms/surgery , Rectum/surgery , Retrospective Studies , Risk Factorsالملخص
OBJECTIVE@#To study the association between maternal Th1/Th2 immune level at different pregnancy stages and cow's milk protein allergy (CMPA) in infants.@*METHODS@#The healthy women with a singleton pregnancy, as well as their offspring, who attended Yidu Central Hospital of Weifang and Qingzhou Traditional Chinese Medicine Hospital from July 2016 to December 2018 were enrolled. The maternal levels of interleukin-2 (IL-2), interferon gamma (IFN-γ), interleukin-4 (IL-4), and interleukin-10 (IL-10) at the second and third trimesters of pregnancy were measured. A CMPA questionnaire survey was conducted within one year after birth. Food avoidance and cow's milk oral challenge tests were performed in infants suspected of CMPA. The 48 infants who met the diagnostic criteria for CMPA were included in the observation group, and the remaining 977 normal infants were included in the control group. A univariate analysis was performed on the infants with CMPA. A Poisson regression analysis was used to determine the association between maternal Th1/Th2 immune factors at different pregnancy stages and CMPA.@*RESULTS@#The detection rate of CMPA was 4.68%. The clinical manifestations included the symptoms of the digestive system, skin, and respiratory system and other symptoms. The univariate analysis showed that compared with the control group, the observation group had significantly higher incidence rates of maternal food allergy and maternal history of allergic diseases (P<0.05) and a significantly lower breastfeeding rate (P<0.05). The observation group had significantly lower maternal levels of IL-2 (second and third trimesters) and IFN-γ (third trimester) than the control group (P<0.05). Maternal low IFN-γ at the third trimester and maternal low IL-2 at the second and third trimesters were significantly associated with CMPA in infants (P<0.05). After correction of the factors of breastfeeding, maternal food allergy, and maternal history of allergic diseases, it was found that maternal low IL-2 and IFN-γ at the third trimester were still significantly associated with CMPA in infants (P<0.05).@*CONCLUSIONS@#The maternal decrease in Th1 level at the third trimester of pregnancy may lead to the change in fetal immunity and thus increase the risk of CMPA in offspring.
الموضوعات
Animals , Cattle , Female , Humans , Infant , Pregnancy , Allergens , Breast Feeding , Milk Hypersensitivity , Milk Proteins/immunologyالملخص
OBJECTIVE: to introduce the study method of Chinese Transanal Total Mesorectal Excision(TaTME) registry Collaborative(CTRC),and report the short-term clinical-oncological outcomes from CTRC. METHODS: Based upon the concept of real world evidence,Data of 601 cases were retrospectively and prospectively analyzed from a nationwide multi-center registry system of CTRC.The safety and effectiveness of these cases were evaluated. RESULTS: The results of the CTRC database showed that:(1) 68.7% of 601 patients were male,the average age of all patients was(59.5±11.4)years,the average BMI was 23.9±3.6. There were 558 cases of rectal cancer among the total enrolled cases. The average distance between the distal edge of rectal cancer and the anal verge was(48.1±14.8)mm,and the ratio of neoadjuvant therapy was 31.7%.(2) 24.6% of the surgical cases were completed under the supervision of TaTME experts. The mean volume of intraoperative blood loss was(115.2 ± 366.5)mL,and the mean operating time was(247.1±87.5)min. Circle stapler was used to make the anastomosis among 74.8% of rectal cancer cases. The protective stoma was performed among 49.6% of the cases of rectal cancer. Maintaining a stable pneumopelvis and excessive smoke obscuring the pelvic view,were the main intraoperative difficulties encountered during transanal procedure. According to the grading of quality and completeness of the mesorectum in the total mesorectal excision specimen,the incidence rates of TaTME specimen graded as "complete", "nearly complete" and "incomplete" were79.6%,16.8% and 0.2% respectively by the evaluation of surgeons.(3)The incidence of postoperative complications was20.2%,and the anastomotic leakage rate was 7.0%.(4) There were 8 cases of specimen perforation. The average number of lymph node harvest was 15.4±7.9. CONCLUSION: TaTME procedure seems be safe and effective regarding to the shortterm clinical-pathological outcomes. The completeness of distal mesorectal dissection,circumferential resection margin and distal resection margin can be promised by the procedure of TaTME. However,the data quality in the database of CTRC needs to be improved,and structured training for TaTME surgery is indispensable. Further national multicenter prospective clinical trials are needed to evaluate the efficacy of TaTME versus TME.
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@#【Objectives】Todevelopagroup2innatelymphoidcell(ILC2)-dominantallergicairwayinflammation modelinwildtypeC57BL/6andT/Bcell-deficientRag1-/- mice.【Methods】FemaleC57BL/6andRag1-/- micewere randomlydividedintocontrolandmodelgroups.Themiceinmodelgroupswereadministeredintratracheallywith1μg IL-33in20μLH2Oondays1,3and5,andthecontrolmicewereadministeredaccordinglywith20μLH2O.Onday6, themiceweresacrificedforcollectionofbronchoalveolarlavagefluid(BALF)andthelungs.Thepulmonaryinflammation inmicewasevaluatedbypathologicalstainingforlungtissues,ELISAforlevelsofcytokinesinBALF,andflowcytometry analyses of ILC2 and inflammatory cells.【Results】Both the C57BL/6 and Rag1-/- mice with the treatment of IL-33 exhibitedobviouseosinophilicairwayinflammationinperi-trachealarea(P<0.05)andgobletcellhyperplasiainairway epithelium(P<0.05).Comparedwiththecontrolmice,numbersofeosinophils(P<0.05)andneutrophils(P<0.05) aswellaslevelsofIL-5(P <0.05)andIL-13(P <0.05)inBALFwereincreasedinthemodelgroup.Inaddition, significantlyhigher levels of ILC2 were found in lung tissues of the model mice.【Conclusion】The ILC2-dominant allergicairwayinflammationwassuccessfullydevelopedinbothC57BL/6andRag1-/-mice,whichprovidedtheapproach toinvestigatetheroleofILC2inasthmaandallergicrhinitis.
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Heparin has been used as first-line anticoagulant clinically for 80 years. Heparin mainly exerts its anticoagulant activity through interaction with ATIII. It has been found there are more than one hundred heparin-dependent functional proteins which demonstrates promising novel application beyond anticoagulant, such as anti-tumor, anti-malaria anti-inflammation, anti-viral, anti-malaria anti-anemia, etc. Heparin is also hopeful to be used as tool for drug delivery vehicle and functionalized implants material. In addition, heparin oligosaccharides are expected to be produced by chemical/enzymatic and bioengineering synthesis. Above mentioned new developments of heparin are covered in this review.
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Objective: To investigate the removal effect of 5 kinds of common flocculants on 6 kinds of toxic alkaloids in processing wastewater of Aconiti Radix. Method: HPLC was employed to determine contents of 6 kinds of alkaloids in the processing wastewater of Aconiti Radix before and after flocculation.The mobile phase consisted of acetonitrile-tetrahydrofuran(25:15)-0.1 mol·L-1 ammonium acetate solution(each 1 L contains 0.5 mL of glacial acetic acid) for gradient elution, volume flow rate was 1.0 mL·min-1, detection wavelength was 235 nm.The removal characteristics and effects of five common flocculants of ferric chloride, aluminum sulfate, polymeric ferric sulfate, polyaluminum chloride/polyacrylamide(PAC/PAM) and sodium polyacrylate were compared and preliminarily optimized. Result: The 5 kinds of flocculants had certain selectivity for different types of alkaloids, and the removal of 6 kinds of alkaloids showed obvious differences.Among them, the PAC/PAM attenuated relative superiority, when the pH 6, adding amount of 0.25 g·L-1 and PAC-PAM dosing ratio of 30:1, comprehensive removal effect was relatively good, removal rates of mesaconitine and hypaconitine was 85.4%and 58.3%, respectively. Conclusion: The flocculation method can be used as a pretreatment process to reduce the toxicity of processing wastewater of Aconiti Radix.
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Objective To investigate and compare the curative effect between delayed percutaneous coronary intervention (PCI) for patients with acute myocardial infarction presenting 12-24 hours from symptom onset and medical therapy on acute myocardial infarction patients presenting with ST-segment elevation (STEMI). Methods Using a prospective,open,parallel,controlled research approach,186 patients with STEMI were divided into delayed PCI group(n=89),which received PCI within 12-24 hours after STEMI and medical therapy group(n=97),which received medical therapy after STEMI. All patients were followed up 1-6 months with average follow-up (5.6 ± 1.4) months. Data of hospitalization period, the cardiac structures detected by echocardiography such as left atrial diameter (LAD), left ventricular diastolic diameter(LVDd),left ventricular ejection fraction LVEF,left ventricular fractional shortening(LVFS),composite end point events and major adverse cardiac events(MACE)were compared between the two groups.Results Compared with medical therapy group, the hospitalization cycle was significantly shorter in delayed PCI group. Data of the LAD and LVDd were significantly decreased,but LVEF and LVFS were increased in delayed PCI group compared with those of medical therapy group at 30 d and 6-month follow-up. The incidence of MACE and composite end point events were significantly less in delayed PCI group than those of medical therapy group (P<0.05). Conclusion Delayed PCI treatment can decrease the time of hospital stay and decrease the incidence rates of MACE and composite end point events,and improve left ventricular function and prognosis of patients.
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Objective To investigate the mechanisms of basic fibroblast growth factor(bFGF) promoting blood spi-nal cord barrier(BSCB) recovery in rats after spinal cord injury(SCI).Methods Rats were randomly divided into sham group,SCI model group, bFGF intervention group(80 μg/kg). The nerve function of hind limb motor was evaluated by Basso, Beattie, and Bresnahan (BBB) scores during postoperative 14 days. Neuron loss of injured spinal cords was observed by haematoxylin and eosin(HE) staining and NeuN staining.The integrity of BSCB was investigated with Evan's Blue staining and fluorescein isothiocyanate (FITC)-dextran extravasation. The expression protein of adhesive connection protein (p120-catenin,β-catenin) and tight junction protein expression(occludin, claudin-5) were analyzed by Western blot.Results Compared with SCI model group, bFGF intervention group neuron loss decreased significantly at 3 d after injury(P<0.05);the permeability of blood spinal cord barrier obvi-ously reduced at 1d after injury; the expressions of p120-catenin, beta-catenin, occludin, claudin-5 protein of bFGF intervention group were increased dramatically at 1 d after injury(P<0.05). Conclusions bFGF improves the recovery of BSCB in an SCI model by reducing the loss of neurons and increasing the expressions of adhesion junction proteins and tight juction proteins.
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OBJECTIVES@#To investigate the role of autophagy inhibitor chloroquine (CQ) in acute ethanol-induced liver injury and its mechenism.@*METHODS@#Twenty-one C57BL/6 male mice were randomly divided into three groups:control group, ethanol group, CQ + ethanol group (=7). Mice in ethanol group were administered 33% (v/v) ethanol at a dose of 4.5 g/kg body weight. Ethanol-induced liver steatosis in each group was detected by hematoxylin and eosin staining. Hepatic lipid accumulation was detected by staining with Oil red O. Hepatic tissue triglyceride (TG) levels, serum aspartate aminotransferase(AST) and alanine aminotransferase(ALT) were determined by biochemical assays. Protein expression of microtubule-associated protein 1 light chain 3(LC3) and nuclear factorκB p65(NF-κB p65) were measured by Western blot and immunofluorescence. Pro-inflammatory factors tumor necrosis factor-α(TNF-α)、interleukin 6(IL-6) were detected by ELISA.@*RESULTS@#Compared with control group, ethanol induced liver injury proved by accumulation of hepatic lipids, TG levels, AST and ALT activities were significantly increased by ethanol, protein expression of LC3-Ⅱ was also markedly increased by ethanol. Compared with ethanol group, addition of CQ increased furtherthe level of LC3-Ⅱexpression, and TG amount, serum AST and ALT activities, and the expression of NF-κB p65, TNF-αand IL-6.@*CONCLUSIONS@#Acute ethanol-intake could induce liver steatosis and inflammation, and autophagy inhibitor CQ exacerbatedethanol-induced liver injury, suggested that autophagy might be protective effect in acute ethanol-induced liver disease.
الموضوعات
Animals , Male , Mice , Alanine Transaminase , Blood , Aspartate Aminotransferases , Blood , Autophagy , Chloroquine , Pharmacology , Interleukin-6 , Liver , Liver Diseases, Alcoholic , Drug Therapy , Mice, Inbred C57BL , Microtubule-Associated Proteins , Metabolism , Random Allocation , Transcription Factor RelA , Metabolism , Triglycerides , Tumor Necrosis Factor-alphaالملخص
Objectives To test the hypothesis that concentration of amniotic fluid alpha-fetal protein (AFAFP) is increased in thalassemia fetus. Methods A total of 135 cases of amniocentesis admitted from July 2013 to December 2014 were included in this study. Among them 98 cases of normal fetuses were assigned into control group and 37 cases of thalassemia fetus were included as thalassemia fetus group. Alpha-fetoprotein levels detected by enzyme linked immunosorbent assay and the alpha-fetoprotein concentration were compared between the two groups. There is no significant difference in gestational age between the two groups. Results 1. AFP concentration in thalassemia fetus group was significantly higher than that of normal control group [(1 541.65 ± 734.78) μg/mL vs. (2 728.84 ± 1 539.97) μg/mL], and amniotic fluid AFP concentration was related to fetal thalassemia. 2. AFAFP concentration in pure α-thalassemia fetus was higher than that of β-thalassemia fetus or mixed α- and β-thalassemia fetus, but the difference was not significant. Conclusions Concentration of amniotic fluid alpha-fetal protein is increased in thalassemia fetus. AFP concentration in α-thalassemia fetus was higher than that of β-thalassemia or mixed α- and β-thalassemia fetus but difference was not significance. Further studies are needed to explore the possible correlation between Down syndrome and biochemical markers of thalassemia.
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OBJECTIVES@#To test the hypothesis that concentration of amniotic fluid alpha-fetal protein (AFAFP) is increased in thalassemia fetus.@*METHODS@#A total of 135 cases of amniocentesis admitted from July 2013 to December 2014 were included in this study. Among them 98 cases of normal fetuses were assigned into control group and 37 cases of thalassemia fetus were included as thalassemia fetus group. Alpha-fetoprotein levels detected by enzyme linked immunosorbent assay and the alpha-fetoprotein concentration were compared between the two groups. There is no significant difference in gestational age between the two groups.@*RESULTS@#1. AFP concentration in thalassemia fetus group was significantly higher than that of normal control group [(1541.65 ± 734.78) μg/mL vs. (2728.84 ± 1539.97) μg/mL], and amniotic fluid AFP concentration was related to fetal thalassemia. 2. AFAFP concentration in pure α-thalassemia fetus was higher than that of β-thalassemia fetus or mixed α- and β-thalassemia fetus, but the difference was not significant.@*CONCLUSIONS@#Concentration of amniotic fluid alpha-fetal protein is increased in thalassemia fetus. AFP concentration in α-thalassemia fetus was higher than that of β-thalassemia or mixed α- and β-thalassemia fetus but difference was not significance. Further studies are needed to explore the possible correlation between Down syndrome and biochemical markers of thalassemia.
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Objective To analyze the genetic phenotypes of Nantong Han population and evaluate the application value of 17 Y-STR loci in Nantong population.Methods The peripheral blood samples were collected from 343 unrelated Nantong Han males and the genomic DNA were extracted by Chelex-100 method.Genotyping was performed using the AmpF(l)STR YfilerTM Kit.The results were compared with other 12 Han populations,including Anhui,Jiangsu,Jiangxi,Shandong,Shanghai,Zhejiang (1),Lanzhou,Nanyang,Luzhou,Mudanjiang,Shanxi and Zhejiang (2),and 9 minority populations (Mongol,Xibe,Tibetan in Lhasa,Tibetan in Qinghai,Kazak,Uighur,Manchu,Paiwan in Taiwan and Tujia).Results A total of 327 different haplotypes were found in 17 Y-STR loci in Nantong Han population.The haplotype diversity (HD) was 0.999 7.The R,value between Nantong Han and other Chinese populations ranged from-0.000 6 to 0.263 5.The multidimensional scaling results showed that Nantong Han population had no significant differences between most of the Han populations,but had significant differences between most of Chinese minority populations.Conclusion Seventeen Y-STR loci can be a powerful tool for forensic application because of its high polymorphism in Nantong Han population.
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Phloretin is a kind of natural dihydrochalcone from the root bark, fruits, and leaves of the apple tree. It’s also found in a variety of plants. Phloretin has remarkable curative effect in anti-inflammatory, antibacterial, antitumor, and other biological activities. So it has a wide range of application prospects. The derivatization of phloretin contributes to the improvement of its biological activity and water solubility. This paper reviews the progress of the derivatization of phloretin and provides a reference for its research and utilization.
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<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of pregnancy-associated acute Stanford type A aortic dissection to improve the maternal and fetal outcomes.</p><p><b>METHODS</b>We analyzed the perioperative data of 5 pregnant women with acute Stanford type A aortic dissection treated between June, 2009 and February, 2017.</p><p><b>RESULTS</b>The median age of the women was 30 years (range, 22-34 years) with gestational weeks of 23-38 weeks upon diagnosis. All the 5 patients received surgical interventions. Three patients underwent caesarean delivery and hysterectomy, and the fetuses survived after the surgery; 2 patients chose to continue pregnancy following the surgery, among whom one died due to postoperative complications and the other underwent termination of pregnancy. During follow-up, the surviving patients showed no endoleak in the descending aorta stent and the distal dissection remained stable.</p><p><b>CONCLUSION</b>The maternal and fetal outcomes of pregnancy-associated acute Stanford type A aortic dissection can be improved by multidisciplinary cooperation and optimization of the surgical approaches according to the time of pregnancy, fetal development and conditions of the aortic lesions.</p>
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<p><b>OBJECTIVE</b>To investigate the clinical and laboratory features of patient with B cell lymphoma associated hemophagocytic syndrome(B-LAHS).</p><p><b>METHODS</b>The clinical data of 10 cases of B-LAHS were retrospectively analysed and the relevant literatures were reviewed.</p><p><b>RESULTS</b>The median age of 10 cases diagnosed as B-LAHS was 55.5 (31-88) years old, and median time from attack to diagnosis was 2 months (2 weeks-4 months). The diagnosis can be made histopathologically and immunohistochemically by bone marrow biopsy. Among them 7 cases were diagnosed as large B cell lymphoma, 2 cases as mantle cell lymphoma and 1 case as small B cell lymphoma. The prominent clinical symptoms and signs were persistent fever (100%) and splenomegaly(90%), and the involvements with respiratory and digestive system were common. Another 1 case had systemic muscle pain and lactic acidosis as the first onset. Laboratory studies showed hepatic dysfunction, significantly elevated ferritin and lactate dehydrogenase, abnormal lymphocytes in peripheral blood smear, and hemophagocytosis in bone marrow smear. The FSC/SSC abnormalities of cloned B lymphoma cells were detected through flow cytometry (FCM). The complete remission (CR) was maintained in 4 cases receiving immunochemotherapy based on rituximab.</p><p><b>CONCLUSION</b>B-LAHS possesses heterogeneous clinical manifestations and rapid deterioration. Bone marrow biopsy and immunohistochemical examination can confirm the diagnosis. FCM may improve the early diagnosis of B-LAHS.</p>
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<p><b>OBJECTIVE</b>To explore the lymphocytic clonal expansion in adult patients with Epstein-Barr virus-associated lymphoproliferative diseases (EBV+LPD), and to investigate the experimental methods for EBV+LPD cells so as to provide a more objective measure for the diagnosis, classification and prognosis in the early stage of this disease.</p><p><b>METHODS</b>Peripheral blood samples from 5 patients with EBV+LPD, 4 patients with adult infectious mononucleosis(IM) as negative control and 3 patients with acute NK-cell leukemia(ANKL) as positive control were collected. Prior to immunochemotherapy, viral loads and clonality were analysed by flow cytometry (FCM), T cell receptor gene rearrangement (TCR) was detected by real-time polymerase chain reaction (RT-PCR), and diversity of EB virus terminal repeat (EBV-TR) was detected by Southern blot.</p><p><b>RESULTS</b>FCM showed only 1 case with clonal TCRVβ in 5 patients with EBV+LPD, TCR clonal expansion could be detected both in patients with IM(4 of 4) and 4 patients with EBV+LPD(4 of 5), Out of patients with EBV+LPD, 1 patient displayed a monoclonal band and 2 patients showed oligoclonal bands when detecting EBV-TR by southen blot.</p><p><b>CONCLUSION</b>Detecting the diversity of EBV-TR by Southern blot may be the most objective way to reflex clonal transformation of EBV+LPD, which is of great benefit to the diagnosis, classification and prognosis in the early stage of this disease.</p>
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<p><b>BACKGROUND</b>The one-step method was routine practices in China, scientific evidence to support this intervention is scarce. The purpose of this study was to observe the natural process of head-to-body delivery interval by waiting for at least one contraction (two-step) after head delivered in normal birth.</p><p><b>METHODS</b>From March 1 to March 30 in 2015 at Haikou Maternal and Child Hospital in China, normal vaginal birth with normal baby condition were recorded by video. Videotapes were transferred to computer then replayed and observed.</p><p><b>RESULTS</b>Ninety-two cases were enrolled in this study. The average head-to-body delivery interval by two-step delivery was 71.04 ± 61.02 s, (mean + 2 standard deviation = 193.07 s, 95% confidence interval [15.65-229.15] s). Fifty-one patients (51/92, 55.43%) were <60 s, 41 patients (41/92, 44.57%) were over 60 s. Shoulders delivered at the first contraction were 96.74% (89/92), 3.26% (3/92) had delivered by the second contraction. Shoulders emerged from perineum were 71.73% (66/92), 15.21% (14/92) transversely, and 13.04% (12/92) emerged from under pubic arch. Babies cried before the shoulder were 31.52% (29/92), cried after birth 52.17% (48/92), and 16.30% (15/92) did not cry after birth. Baby activities included as making faces, sucking, and bubbled from mouth and noses, and the lighter blue color of skin with good perfusion.</p><p><b>CONCLUSIONS</b>The average time of head-to-body delivery interval was longer than 60 s by two-step delivery. Majority shoulders were delivered at the first contraction. Majority shoulders emerged from perineum rather from under pubic arch. The routine one-step method of shoulder delivery where the downward force applied is not necessary and is not the right direction. Baby's breath, making faces, sucking, bubble from noses and mouth, and the light blue color of the faces, all those signs during shoulder delivery indicated a normal live birth.</p>
الموضوعات
Adult , Female , Humans , Infant, Newborn , Pregnancy , Delivery, Obstetric , Reference Values , Shoulder , Time Factors , Uterine Contractionالملخص
<p><b>OBJECTIVE</b>To observe the the expression of endoplasmic reticulum stress (ERS) related factors in deep tissue injury (DTI) at pressure ulcer rat and to investigate the ERS mechanism of DTI in muscle tissue and protective effect of 4-phenylbutyric acid (4-PBA) in local tissue.</p><p><b>METHODS</b>Fifty male SD rats were randomly devided into control group, model group, experimental group NS group and PBA group, the experimental groups were divided into 4 d, 7 d, 14 d and 21 d group according to the observation time (n = 5). Rats in the PBA group were administrated with gastric perfusion of 4-PBA after the modeling; the NS group was given normal saline of the same quantity. Using HE staining to observe morphologic character. The expression of glucose regulated protein 78 (GRP78), CHOP, Caspase 12 were detected by immunohistochernical staining. Cell apoptosis was detected by TUNEL assay.</p><p><b>RESULTS</b>HE staining results showed that each group demonstrated compression injury compared with control group: cellular swelling, ompaction of nuclear, and apoptosis in muscle tissue. The new muscle fiber in 4-PBA group fused faster than those in NS group. The number of TUNEL positive cells peaked at 4 day after compression, then got decreased on day 7 in muscle tissue, apoptosis positive cells were diminished after 4-PBA treatment. The immunohistochemical staining results showed that the expression of protein GRP78, CHOP, Caspase 12 peakd 4 d after modeling and decreased gradually. The GRP78, CHOP, Caspase 12 protein expression were significantly higher than those of PBA group at all time points (P < 0.05).</p><p><b>CONCLUSION</b>Cell apoptosis induced by endoplasmic reticulum stress took part in deep tissue injury resulting of pressure ulcer, which mechanism might be related to reducing apoptosis mediated by CHOP, Caspase 12.</p>