Objective　To investigate the changes and its clinical significance of plasma neuropeptide Y(NPY) concentration in patients with pregnancy induced hypertension (PIH). Methods　Plasma NPY levels were detected by radioimmunoassay in 30 patients with PIH, 20 normal non-pregnant women and 23 normal pregnant women. The PIH group was subdivided into mild, moderate and Severe subgroups, and the NPY concentration was also measured in these subgroups respectively at admission and one week after delivery. Results　The plasma NPY levels in patients with PIH ［(164.16±68.32) ng/L］ were significantly higher than those of normal non-pregnant women and normal pregnancies ［(86.60±20.65) ng/L, (82.42±12.46) ng/L, P<0.01, respectively］. There was significant difference among plasma NPY levels among the patients with mild, moderate, and severe PIH at admission (P<0,01). At one week after delivery the concentrations of plasma NPY were significantly decreased in the moderate and severe subgroups compared with the value measured at admission (P<0.01). Moreover, the NPY levels in patients with severe PIH after delivery were still higher than those of normal non-pregnant women. Conclusions　The results suggested that the level of NPY in plasma is increased in women with PIH. Elevated plasma NPY levels may play a key role in the development of PIH.

Objective To investigate the risk factors of incidence of premature rupture of membranes and provide reference for prevention of premature rupture of membranes.Methods 890 cases of infants and maternal were studied,analyzing and screening the risk factors of premature rupture of membranes by Logistic.Results The single-factor analysis showed that the pregnant women with diabetes,pregnancy-induced hypertension,multiple preg-nancy and vaginifis had certain degree of contact with incidence of premature rupture of membranes.Multivariate Lo-gistic regression analysis showed that the multiple pregnancy and vaginitis were risk factors of incidence of premature rupture of membranes.Conclusion The multiple pregnancy and vaginitis were risk factors of incidence of premature rapture of membranes,assessment and control these risk factors could prevent and reduce the incidence of premature rupture of membranes.

If we can add how to avoid medical dispute into clinical education,it must be very helpful to young doctors in their medical work after graduation.The article analyzed the cause of medical dispute,and proposed how to enhance the education of medical dispute avoiding,and prove a efficient way to improve clinical education.

Objective　To study the association of plasma von willebrand factor (vWF) and endothelin-1(ET-1) levels in patients with pregnancy induced hypertension (PIH). Methods　Plasma vWF and ET-1 were studied by ELISA method and immunoradiological method respectively in 36 patients with PIH, 18 normal pregnant women and 19 normal non-pregnant women. Results　Circulation levels of vWF and ET-1 were increased with increasing severity of the PIH. In mild PIH patients, the levels of plasma vWF ［(135.9±30.9)%, （P>0.05)］ weren′t significantly higher than those in healthy pregnant women ［(131.6±39.2)%,（P>0.05)］，but the levels of ET-1 ［(63.7±4.8) pg/L］ were significantly higher than those in healthy pregnant women ［(47.1±4.7) pg/L,（P<0.01)］. There were significant differences between groups of moderate-severe PIH ［vWF (174.4±35.4)%, ET-1 (92.6±19.1) pg/L］. There was a positive correlation between the plasma vWF level and ET-1 level. Conclusion　The results suggested that plasma vWF and ET-1 concentration could be used as indicators for the severity of PIH.

Objective To study the effects of hypotensive resuscitation on microvascular perfusion in a clinically relevant model of uncontrolled hemorrhagic shock in pregnancy. Methods Thirty New Zealand white rabbits at 15 -25 days, pregnanal age were randomly divided into three groups; Group normal saline traditional aggressive resuscitation ( NS), traditional aggressive resuscitation in the prehospital phase with a large quantity of normal saline and Ringer's solution to maintain mean arterial pressure (MAP) at the approximately 80 mm Hg ( 1 mm Hg = 0.133 kPa) level: Group normal saline hypotensive resuscitation (NH) and group hypertonic hyperosmotic hypotension resuscitation (HHH), hypotensive resuscitation in the prehospital phase with a bolus dose of 4 ml/kg normal saline or hypertonic hydroxyl ethyl starch (10% hydroxyl ethyl starch + 7.5% NaCl), followed by Ringer's solution to maintain MAP at 60 mm Hg.Production pregnant rabbit model with hemorrhagic shock. The experiment consisted of four phases:basic phase (0 miniutes), shock phase (0- 30 miniutes), prehospital phase (30- 90 miniutes) and hospital phase (90- 180 miniutes). Measurements: (1) arteriole and venule diameter were continuously monitored by microcirculatory detecting instrument; (2) functional capillary density (FCD) of each phase was expressed by the percentage of opening capillaries segments relative to basic phase; (3) blood pH, BE PCO2, PO2 in pregnant rabbits were determined with a Medica Easy Blood Gas Analyzer. Results ( 1 )There were no significant differences among three groups in arteriole and venule diameter at baseline ( P ＞0.05 ). After hemorrhagic shock arteriole diameter were NS ( 50.8 ± 5.6) μm, NH (47.6 ± 3.7 ) μm, HHH (51.3 ±2.4)μm, respectively, with no significant differences between groups(P ＞0.05). At the end of prehospital resuscitation phase and hospital resuscitation phase, significant differences were found in arteriole diameter in group NS(52.8 ± 4.9, 56.0 ± 3.8 )μm, NH (61.3 ± 2.9, 65.4 ± 3.2 )μm and HHH group (67.0 ± 4.1,74.1 ± 4.8 )μm ( P ＜ 0.05 ); after hemorrhagic shock venule diameter were NS(79.6 ± 7.0)μm, NH (75.3 ±5.3)μm and HHH(76.2 ±5.8)μm, respectively, with no significant differences between groups(P ＞0.05 ). At the end of prehospital resuscitation phase and hospital resuscitation phase,venule diameter were NS(81.1 ± 6.7, 84.4 ±6.0)μm, NH(82.8 ± 3.3, 85.4 ±4.3) μm and HHH (86.9 ± 5.8, 89.4 ± 6.8)μm, respectively, with no significant differences between groups ( P ＞ 0.05 ). (2) The values of FCD in every groups were all 100%. After hemorrhagic shock FCD were NS(39.8 ±6.8)%, NH (43.9 ±4.0)%, HHH(44.0 ± 4.8)%, respectively, with no significant differences between groups(P ＞0.05); at the end of prehospital resuscitation phase and hospital resuscitation phase, FCD were NS(54.5 ±7.3,59.7 ±4.8)%,NH(63.1 ±5.8,70.3 ±5.6)% and HHH (80.5 ±6.9, 91.7 ±4.7)%,respectively, with significant differences between groups( P ＜ 0.05 ). (3) Blood gas parameter: the values of blood pH, BE, PO2, PCO2 in pregnant rabbits in all groups were within normal bounds at basic phase. Shock phase induced typical hyperventilation in all groups, with increase of arterial PO2 and decrease of PCO2; at the end of hospital resuscitation phase, there were no significant difference among the three groups in the values of blood PCO2 ( P ＞ 0.05 ); the values of blood PO2 at the hospital resuscitation phase were significantly lower in NS groups than corresponding values in the other groups (P ＜ 0.05 ). After hemorrhagic shock there was significant metabolic acidosis as shown by decrease of pH, BE; at prehospital resucitation phase, pH, BE values tended to increase in all the groups but not reach to base period. At the end of hospital resucitation phase. The pH, BE value was significantly higher in NS group than those in the other two groups( P ＜ 0.05 ) . (4) Median survival time in NS (2.1 ± 0.2) days group was significantly shorter than NH(3.0 ±0.3) days and HHH(3.6 ± 0.3) days group( P ＜ 0.05). FCD at the end of the hospital resuscitation were significantly related with survival time ( r = 0.655, P = 0.000 ). Conclusion Compared with traditional aggressive fluid resuscitation, hypotensive resuscitation reduce constriction of arterial and venule diameter, increase FCD, alleviate metabolic acidosis and improve long-term survival Hypertonic hydroxyl ethyl starch resuscitation ameliorate microcirculation without improving survival rate.

Objective To discuss the clinical features,management,pregnancy outcome and prognosis of obstetric mirror syndrome.Methods The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management,pregnancy outcome and prognosis.Results ( 1 ) Etiology:12 cases with obstetric mirror syndrome included 9 cases of Bart's hydrops fetalis,2 cases with fetal complicated congenital cardiac anomalies,and 1 case of unknown etiology.(2)Gestational age at diagnosis and at delivery:gestational age at diagnosis ranged from 28 to 36 weeks [ mean (31.5 ±4.7) weeks],and gestational age at delivery ranged from 28+3 to 38 weeks [ mean (32.9 ±2.9)weeks].There were no significant differences between the gestational age at diagnosis and at delivery in consistented with severe preeclampsia group and mild preeclampsia group [ (31.8 ± 2.3 ) weeks vs.(30.9 ± 7.2) weeks,(32.5 ± 2.3 ) weeks vs.(33.5 ± 3.9 ) weeks,P ＞ 0.05 ].( 3 ) The patients with obstetric mirror syndrome can present a preeclampsia-like syndrome:maternal extremity edema in 12 cases,headache and visual disturbance in 1 case,proteinuria in 11 cases,elevated blood pressure in 5 cases,elevated uric acid in 9 cases,hypoproteinemia in 12 cases,elevated creatinine in 3 case,elevated liver enzyme in 1 case,thrombocytopenia in 2 cases.The major complications included 1 case of HELLP syndrome,acute pulmonary edema,placental abruption,amnionic fluid embolism,DIC respectively,3 cases of acute kidney failure and 6 cases of postpartum hemorrhage.(4) Sonographic findings:① Hydrops fetalis:fetal ultrasound revealed pleural fluid,fetal ascites,skin edema,scalp edema,encephalocolele enlargement, hydropericardium and increased cardio-chest ratio.②Placenta megaly:the placental pathological examination revealed edematous and large in 12 cases.Placental thickness was beyond 4 cm in all cases [ (6.3 ± 1.9) cm ].③Hydramnios:hydramnios could be found in 11 cases [ amniotic fluid index ( 19.7 ± 3.1 ) cm ]. (5) Postnatal conditions:all blood pressure and laboratory findings including urine protein normalized within 5 to 7 days after delivery. (6) Pregnancy outcome:all 12 patients survived,however the perinatal mortality rate was 100％.Two of 12 cases with mirror syndrome underwent cesarean section,and 10 were vaginal delivery,of which 1 need uterine artery embolisom due to postpartum hemorrhage.Conclusions Obstetric mirror syndrome seems to simulate preeclampsia although there are distinguishing features,such as hemodilution,placental edema,and polyhydramnios.When the specific cause of obstetric mirror syndrome can not be identified and corrected,the decision for delivery should be made as soon as possibly.

Objective To study on the expressions of IL-8mRNA,MCP-1mRNA and MIP-1mRNA and the counts of TAM and MC and their correlation in ovarian adenocarcinoma tissues.Methods detecting the expressive levels of IL-8mRNA,MCP-1mRNA In situ hybridization were derected,and MIP-1?mRNA and Envision immunohistochemistry wes used for the counts of TAM and MC.Results The positive rates of IL-8mRNA,MCP-1mRNA and MIP-1?mRNA expressions and the counts of TAM and MC were significantly lower in the cases of histologic grade G1,clinical stage Ⅰ+Ⅱ,no-metastasis of regional lymph node,and no-infiltration of peritumoral tissues than those in the ones of histologic grade G3,clinical stage Ⅲ+Ⅳ,metastasis of regional lymph node,and infiltration peritumoral tissues(P

AIM AND METHODS: Using Ca 2+ -sensitive fluorescent probe Fura-2,we measured the changes of _i in cultured rat pulmonary artery endothelial cells (PAEC) and porcine pulmonary artery smooth muscle cells (PASMC) from normoxic (NC group) or chronic hypoxic group (CH group) when they were exposed to acute hypoxia. RESULTS: The increase in _i in 6th passage of PASMC caused by acute hypoxia in CH group was significantly lower than that in the same passage of NC group (P

Objective To evaluate the clinical effect of ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment in managing postpartum bleeding due to pernicious placenta previa. Methods Clinical data of 227 patients with pernicious placenta previa, admitted to Shenzhen Maternity and Child Healthcare Hospital between June 2010 and June 2013, were retrospectively analyzed. Eight-two women,who were admitted between June,2010 to December,2011, receiving B-Lynch sutures combined with uterine lower segment packing after delivering the baby and placenta during cesarean section were assigned as the control group. Another 145 cases, who were admitted between January 2012 to June 2013, receiving ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment, were defined as the observational group. Several indicators during and after the operation were compared between the two groups. T-test or Chi-square test were applied for statistics. Results The duration of operation in the observational group was shorter than in the control [(92±26) vs (106±32) min, t=3.579, P<0.01]. The estimated blood loss during the operation, the total blood loss during the first 24 h after delivery and the blood loss during the operation for placenta percreta in the observational group were all lower than in the control [(1 230±481) vs (1 858±632) ml, (1 475±236) vs (2 482±364) ml, and (2 131±515) vs (2 587±498) ml, t=8.413, 25.295 and 6.484, all P<0.01]. The adjusted postoperative hemoglobin values of the observational group were significantly higher than that of control [(82±21) vs (69±19) g/L, t= - 4.634, P<0.01]. Besides, significant differences were found between the observational and control group on the rates of hysterectomy, blood transfusion, and uterine artery embolization [1%(2/145) vs 7%(6/82), 40%(58/145) vs 66%(54/82), 2%(3/145) vs 12%(10/82), χ2=5.408, 13.945 and 9.904, P < 0.05 or 0.01]. The dosage of Carboprost Tromethamine required was smaller in the observational group [(573±104) vs (729±128) μg, t=9.971, P<0.01]. Conclusions Ligation of descending branch of uterine artery and compression sutures in the lower uterine segment during cesarean section in women with pernicious placenta previa is an effective and simple method to control bleeding resulting reduction of blood loss and the hysterectomy rate.

Objective To discuss the prenatal ultrasound manifestations of Apert syndrome. Methods The prenatal ultrasound features of 4 fetuses identified as Apert syndrome after detailed antenatal ultrasound examinations between January, 2010 to Februry, 2014 in our hospital were analyzed. The ultrasound images and postnatal outcome or autopsy were compared to analysis the sonographic features of Apert syndrome in prenatal. Results The prenatal ultrasound characteristics and pregnant outcome of the 4 fetuses were showed as followings:(1) Skull deformity:4 fetuses were all appeared as acrocephaly, coronal suture premature close and frontal protrusion, while 3 cases (case 1-3) had“clover leaf skull deformity”features. (2) Midfacial malformation deformity:3 cases (case 1-3) were all with hypertelorism and mid-sagittal facial proifle abnormal and only 1 case (case 2) had nose hypoplasia. (3) Limbs abnormal:4 cases were all appeared as bilateral symmetry syndactyly of hands and 1 case (case 2) was diagnosed as bilateral symmetry syndactyly of feet. (4) Associated abnormality:persistent right umbilical vein in 1 case (case1), thoracic spine stenosis in 1 case (case 2), hyperechogenic renal parenchyma in 1 case (case 3) and left-diaphragmatic hernia in 1 case (case 4). (5) The pregnant outcome:3 cases underwent pregnancy termination and 1 case was labored at term. The 3 cases (case1-3) were diagnosed as bilateral symmetry syndactyly of feet after induced labor. The cleft palate and bilateral symmetry syndactyly of feet were misdiagnosed in the full-time infant (case 3), who was died two days after birth. Conclusions The Apert syndrome is a rare syndrome. It generally has typical characteristic of prenatal ultrasound, such as coronal suture premature close, acrocephaly, mid-sagittal facial profile abnormal and bilateral symmetry syndactyly of hands and feet. Prenatal diagnosis of Apert syndrome can play an important role in genetic counseling and postnatal treatment.