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OBJECTIVE: The aim of this study was to investigate the diagnostic efficacy of thrombelastography (TEG) in patients with preeclampsia. METHODS: One hundred and seventeen pregnant women were recruited from Department of Obstetrics and Gynecology of 1st affiliated Hospital of Fujian Medical University. Of the 117 patients, 59 were normal late gestation (control group), 32 were mild preeclampsia and other 26 cases were severe preeclampsia. All the patients were received thrombelastography (including: K time, Reaction time, Clot angel, MA value, CI value) and blood coagulation examination (including: PT, APTT, Fib, TT, D-dimer and AT-III). RESULTS: The R time, K time, Coagulation Index value and Clot Angle in preeclampsia group were significant different between control and preeclampsia groups with statistical difference (p<0.05). Moreover, the R and K time value in severe preeclampsia group were significant higher than those of control groups (p<0.05); however, the Coagulation Index value and Clot Angle in severe preeclampsia group were significant higher than those of mild preeclampsia group with statistical difference (p<0.05). Coagulation Index had the highest diagnostic sensitivity [87.93 (76.70-95.01) %] and specificity [83.83 (79.17-96.18)%] compared to other parameters with the AUC of 0.94 (0.90-0.98). The K time and the Coagulation Index had the highest diagnostic sensitivity (96.15%) and specificity (0.75%) respectively with the AUC of 0.68 and 0.75 respectively in differential diagnosis of severe preeclampsia from mild preeclampsia. However, there were no statistical difference in the aspects of platelet count and parameters relevant to coagulation test for the control, mild and sever preeclampsia groups(p>0.05). CONCLUSION: TEG provides more accurate information in monitoring the blood coagulation of preeclampsia patients and can be used as a reliable marker for assessing the severity of preeclampsia.
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OBJECTIVE: To evaluate the expression and correlations of liver X receptor alpha (LXRa) and its target gene sterol regulatory element-binding protein-1c (SREBP-1c) in placentas of preeclampsia (PE) and their significance in PE. METHODS: Pregnancies were divided into two groups, 60 cases (29 cases of mild and 31 cases of severe) of PE group and 56 cases of normal group. The level of mRNA and protein of LXRa and SREBP-1c were analyzed by reverse transcription-polymerase chain reaction (RTPCR) and immunohistochemistry (IHC) in the placentas. RESULTS: RT-PCR and IHC results showed that the mRNA and protein expression of both LXRa and SREBP-1c increased gradually with the extent of PE among normal pregnancy, mild PE and severe PE groups, and the differences were of statistically significance (P<0.01 or P<0.05). There were positive correlations between the expression of LXRa mRNA and SREBP-1c mRNA, also between LXRa mRNA and LXRa protein (r=0.521, P<0.01; r=0.422, P<0.01). The expression of SREBP-1c mRNA positively correlated with its protein level (r=0.598, P<0.01). There were positive correlations between the expression of LXRa protein and SREBP-1c protein (r=0.612, P<0.01). CONCLUSION: The expression of LXRa is elevated significantly in placentas of PE patients, and might contribute for promoting the transcription and translation of its target gene SREBP1-c, which is related to the occurrence and development of PE.
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Objective To evaluate the expression and discussion on high mobility group protein ( HMGB1 )/toll like receptor 4 ( TLR4 ) and NF-κB possible role in the signaling pathway in preeclampsia .Methods Ten patients with mild preeclampsia(MP), 20 patients with severe preeclampsia (SP) and 30 cases of normal pregnancy were recruited the same period.To check the expression of the HMGB1,TLR4,NF-κB P65 protein in placenta tissue using Immunohistochemical staining .Levels of HMGB1, TLR4, NF-κB P65 in blood serum were measured by ELISA.Results 1)ExpressionofHMGB1,TLR4,NF-κBP65wereincreasedascomparetocontrolgroup(P<0.05);HMGB1,TLR4,NF-κB P65 in placenta of patients with severe preeclampsia and mild preeclampsia failed to show significant difference .2) HMGB1,TLR4,NF-κB P65 in women with preeclampsia was significantly higher than control group ( P<0.05 ); HMGB1,TLR4,NF-κB P65 in women with severe preeclampsia showed a higher level as compared to mild preeclampsia (P<0.05).Conclusions HMGB1,TLR4 and NF-κB P65 were over-ex-pressed in the placenta tissue and serum in patients with preeclampsia , which indicated that HMGB1,TLR4 and NF-κB P65 may play an important role in the development of preeclampsia .
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Objective To assess the feasibility,safety and efficacy of endoscopic papillectomy (EP) for tumors at the ampulla of Vater (AV).Methods A total of 15 patients with tumor at AV that were indicated for EP were included in this prospective study.Their clinical profiles,procedural parameters and outcome were evaluated.Results All patients underwent EP procedure successfully.Four patients who were diagnosed as having chronic inflammation in the reference endoscopy were confirmed as having adenoma after EP.Out of the 11 patients who were previously diagnosed as andenoma on biopsy,2 of low differentiated adenocarcinoma,1 of well differentiated adenocarcinoma and 1 malignant transformation were pathologically confirmed after EP.Stents were implanted in 8 patients with dilated pancreatic and/or common bile duct.Except for 2 cases of melena and 2 transient elevated level of blood amylase after EP,no other major complications occurred.Three patients,including 1 case of low-differentiated adenocarcinoma,1 case of malignant transformation and 1 case of lesion residual,were referred to surgery,another patient with low-differentiated adenocarcinoma declined any additional intervention because of old age.In the remaining 11 cases ( 11/15,73.3％ ) including one well differentiated adenocarcinoma,no recurrence was observed during a follow-up period of 23.4 (5 to 47) months.Conclusion EP is a minimal invasive,safe and effective treatment for tumors at AV,which also can provide an accurate staging of the lesion.
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Objective To assess the expression of thioredoxin reductase(TR)and thioredoxin (Trx)mRNA,TR activity in human placenta in women with preeclampsia,and to discuss the relationship between Trx system and the pathogenesis of preeclampsia.Methods Twenty-sixwomen with preeclampsia(10 mild and 16 severe)and 28 healthy gravidas (control) were included in this study.Semi-quantitative reverse transcription polymerase chain reaction(RT-PCR)were employed to demonstrate the expression of TR and Trx in placentas.TR activity was measured spectrophotometrically.Results The expression of TR mRNA(mild:0.865±0.018;severe:0.800±0.025,P＜0.05)and Trx mRNA(mild:0.873±0.008;severe:0.818±0.025,P＜0.05)were lower in placenta of preeclampsia than in the control group(TR mRNA:0.893±0.023;Trx mRNA:0.918±0.023.P＜0.05),and those levels in the severe preeclampsia group were lower than in the mild ones.Both the mild and severe preeclampsia groups showed lower TR activity than the control(mild:17.732±1.653;severe:15.626±1.543 vs 19.770±2.432,P＜0.05),and that of the severe preeclampsia group was lower than that of the mild ones.Positive correlation was found between the TR activity and TR mRNA expression in both groups(r=0.612,P＜0.001).Conclusions Abnormal decreased expression of TR mRNA and Trx mRNA and TR activity in human placenta of preeclampsia might participate and play an important role in the pathogenesis of preeclampsia.
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Objective To investigate the level of serum vascular endothelial growth factor and soluble vascular endothelial growth factor receptor-1 in patients with pre-eclampsia and eclampsia.Methods Serum vascular endothelial growth factor and soluble vascular endothelial growth factor receptor-1 in peripheral venous blood were determined by ELISA in patients with pre-eclampsia(n=9),severe pre-eclampsia(n=10) and eclampsia(n=5)(total eclampsia n=24) and healthy controls(n=18).Results Patients with pre-eclampsia and eclampsia had higher level of serum sVEGFR-1(pre-eclampsia:58?7 mg/L,severe pre-eclampsia:82?15 mg/L,eclampsia:96?13 mg/L vs control:11?3 mg/L,P
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Objective: To understand the impact of the career planning counseling on college students' life education and to explore an effective way of it;Ways: To influence the experimental classes through lectures,conversation guide,broadcast courseware and guiding team during a period of seven months and to measure the experimental results through questionnaire survey and field interviews.Results: after the experimental class students are superior to the control class students in academic performance,activities participation,mental outlook,attitude to life and psychological health significantly.Conclusion: Career planning counseling has a positive impact on life education.