Objective To analyze the clinical presentation and maternal neonatal outcome of 30 cases with HELLP syndrome and to discuss the diagnosis, treatment and prognosis of the disease. Methods 30 cases of HELLP syndrome were collected retrospectively including 19 cases of complete HELLP syndrome and 11 partial HELLP syndrome. The blood test, clinical presentations, complications and pregnant outcomes were analyzed. Results LDH value in complete HELLP group(CHG) [(622?481)U/L] was significantly higher than that in partial HELLP group(PHG) [( 369?101) U/L, P

ObjectiveTo understand the implementation effect and its influencing factors of clinical medical undergraduates' talents cultivation scheme in Xinjiang Medical University. Methods 421 clinical medical students completed questionnaire. The main contents of the survey are general situation, the factors and the implementation effect of the cultivation scheme, and so on. Results①The talents cultivation scheme is reasonable and feasible. ②The main factors which affect talents cultivation scheme of our school are the teaching plan arrangement and practical course arrangement. ③Talents cultivation scheme in the implementation process achieved some success, but the cultivation of humanistic quality should be enhanced, etc. ConclusionRenewed the education conception, optimize the clinical teaching structure, integrated teaching contents, updated teaching methods and means, and strengthened students' humanistic quality are the key factors of the higher medical institutions to cultivate high quality and comprehensive talents.

0. 05). No significant difference was found in maternal and neonatal complications between the ANCA( + ) and ANCA(－) subgroups in S-PE subjects. But those 4 cases who developed renal function insufficiency patients were ANCA( + ). Conclusions ANCA might be associated with renal diseases in preeclampsia women, and further studies is required to determine whether ANCA is involved with the pathogenesis of preeclampsia.

OBJECTIVE:To explore the basic principles,advantages and application prospects of Bayesian mixed treatment comparison (MTC),and provide theoretic support for making reasonable decisions of pharmacoeconomics. METHODS:The prob-lems existing in model and method that had been used in the study of pharmacoeconomics as starting point,literature research was used to sort out the domestic development and applications of MTC and study its application and development prospect. RESULTS &CONCLUSIONS:The evaluation methods of pharmacoeconomics play an important role in selection of essential medicines,medi-care insurance directory medicines,basic health and basic public health programs,the results directly affect the total effective rate of medical resources’configuration. The current research models cannot effectively solve the problem,for example,decision tree model is difficult to make evaluation of long-term treatment;Markov model and the use of multiple attribute utility theory are restricted by the model parameters;discrete event simulation is limited because it depends on the epidemiological study and clinical trial. MTC, an extension approach of the traditional Meta-analysis,is an effective new method developed recently to analyze and compare the di-rect or indirect evidence of several different clinical treatment factors in order to make a comprehensive evaluation of the various inter-ventions in the absence of evidence support. So the MTC can make up for the limitation of current evaluation methods.

Objective To investigate the incidence changes, clinical characteristics and pregnant outcomes of pernicious placenta previa. Methods A retrospective cohort analysis on 316 cases with placenta previa in the Peking University First Hospital from January 2008 to December 2014. The research group were 60 cases with the patients of placenta previa with the history of cesarean section, and the control group were placenta previa without the history of cesarean section. Compared with the incidence, intraoperative blood loss, the pregnancy outcomes and so on. Results (1) The average incidence rate of placenta previa during the past 7 years was 10.96‰ (316/28 837). And the cases of pernicious placenta previa was 60 (2.08‰, 60/28 837), the incidence of pernicious placenta previa was rising from 2008 to 2014 (0.91‰-3.08‰). (2) There were 145 cases of placenta privia had been translation from other hospitals in the past 7 years. The referral rate of pregnant women with placenta previa was 45.9%(145/316), and the referral rate of pernicious placenta previa (63.3%, 38/60) was significantly higher than that of non-pernicious placenta previa group (41.8%, 107/256; χ2=9.080, P=0.003). Referral the outcomes of these patients were good, and no maternal death occurred. (3) The placenta in the research group were mainly adhered in the front wall of the uterine, and the incidence was 38.5%(15/39), higher than that in the group of non-pernicious placenta previa (12.1%, 21/174; χ2=57.636, P<0.01). The incidence rate of complicated placenta increased in research group was 53.3% (32/60), higher than that in the group of non-pernicious placenta previa, compared with the control group, there was significant difference (15.6%, 40/256; χ2=39.041, P<0.01). (4) The incidence of blood loss was more than 1 000 ml, blood transfusion rate, the rate of hysterectomy and the rate of asphyxia of newborn in the research group were respectively 41.7% (25/60), 38.3%(23/60), 8.3%(5/60), 15.0%(9/60), and the incidence of the group of non-pernicious placenta previa were respectively 4.7%(12/256), 12.9%(33/256), 1.2%(3/256), 8.6%(22/256), compared those in other two groups, there were not significant difference (P<0.05). Conclusions The incidence rate of placenta previa increased year by year, patients with placenta previa has a history of cesarean section often combined with placenta in anterior wall of the uterus, and often with poor pregnancy outcomes. Hierarchical referral system is an effective means to reduce the mortality of the pernicious placenta previa.

Objective To investigate the relationship between placental endoglin expression and the pathogenesis of severe preeclampsia (SPE). Methods Forty nine pregnant women with SPE and 40 normal pregnant controls were collected in Peking University First Hospital from January 2006 to January 2008,among which,nine SPE patients complicated with fetal growth restriction (FGR),six with hemolysis,elevated liver enzymes and low platelets syndrome (HELLP syndrome) and 12 with heavy proteinuria. The expression of placental endoglin was detected and semi-quantified by immunohistochemistry.Data were analyzed by independent sample t test. Results Endoglin was presented on cell membranes of placental syncytiotrophoblasts and vascular endothelial cells. The endoglin density of SPE group was higher than that of control group (0.1621± 0.0029 vs 0.1576 ± 0.0038,t=- 6.367,P＜0.05).No significant difference in endoglin density was found between FGR group and non-FGR group (0.1611±0.0026 vs 0.1623±0.0029,t=1.107,P＞0.05) ; neither did the heavy proteinuria group and non-heavy proteinuria group (0.1611±0.0032 vs 0.1624±0.0027,t=1.350,P＞0.05).The endoglin density of HELLP group was lower than that of non-HELLP group (0.1595±0.0032 vs 0.1625±0.0027,t=2.495,P=0.016). Conclusions The elevated placental endoglin expression might contribute to the pathogenesis of SPE.

Objective To discuss the serum endoglin expression in severe pre-eclampsia and eclampsia women and their relationships. Methods Forty-two severe pre-eclamptic patients and 4 eclamptic patients in Peking University First Hospital from Dec. 2005 to Dec. 2007 were enrolled in the study group, with the mean gestational week of 35 ± 4, the mean age of 29.3 ± 5.7 and the mean BMI (30.1 ± 4.1 ) kg/ m2. This group included 25 cases of early onset pre-eclampsia, 21 cases of late onset pre-eclampsia, 8 cases of fetal growth restriction and 5 cases of HELLP syndrome. The control group included 29 cases of normal pregnant women during the same period, with the mean gestational week of 33±4, the mean age of 30.7± 3.4 and the mean BMI(27.2±2. 2) kg/m2. Peripheral serum endoglin was determined by ELISA in these two groups. Results (1)There is positive correlation between serum soluble endoglin level and the gestational weeks during 27 to 37 gestational weeks in the control group (r=0.79, P<0.05), but there is no distinct relationship in the study group (r=0.31, P>0.05). (2) Serum endoglin level of severe pre-eclampsia group was higher than the normal group [(14.2±5.6)μg/L vs. ( 10.9 ± 4.2 ) μg/L, P<0.05]. (3) Serum endoglin level of early onset group did not differ from late onset group [(14.3±5.7)μg/L vs. (13.6±5.0)μg/L, P >0.05]. (4) No difference of serum endoglin between HELLP group and non-HELLP group was found [(10.1±2.9) μg/L vs. ( 14.4±5.4) μg/L, P>0.05 ]. (5) Serum endoglin level of FGR sub group was higher than non-FGR sub group [(17.3±6.1) μg/L vs. (13.0±4.8) μg/L, P < 0.05] in the stady group. Conclusion The elevated peripheral serum endoglin level may contributes to the pathogenesis of severe pre-eclampsia and FGR, but not the week of the onset of the disease.

Objective To study the clinical significance of chromosome karyotyping in pregnant women with a history of abnormal pregnancy. Methods The fetal chromosome karyotypes of 1 193 pregnant women with a history of abnormal pregnancy in Peking University First Hospital from January 4, 2005 to December 31, 2013 were analyzed. According to the etiology of their previous abnormal pregnancy, these women were divided into four groups: 273 women had children with inherited metabolic disorders or single-gene genetic diseases (group A), 81 women had children or fetuses with chromosome abnormalities (group B), eight cases had an abnormal chromosomal karyotype in either husband or wife (group C), and 833 women had abnormal pregnancy of unknown causes(group D). Results Forty-eight [4.0%(48/1 193)] and fetuses were found to have abnormal chromosomal karyotypes, including 26 cases of chromosome polymorphism variations and 22 cases of numerical and structural abnormalities (four cases of trisomy 21, four cases of numerical sex chromosome abnormalities, three cases of trisomy 18, three cases of extra small chromosome mosaicism, three cases of reciprocal translocation, one case of Robertsonian translocation, one case of chromosome six inversion between the arms, one case of chromosome three inversion between the arms, one case of mosaicism of trisomy 14 and one case of structural abnormality of chromosome 14). In group A, four cases (1.5%) of chromosomal abnormalities of clinical significance and four cases of chromosome polymorphism variations were detected. Meanwhile, 61 fetuses with inherited metabolic disorders or single-gene genetic diseases and two cases of gene mutation carriers were detected in group A, but among whom, there were no abnormal chromosome karyotype cases. In group B, two cases (2.5%) of chromosomal abnormalities were found. In group C, two cases (2/8) of reciprocal translocation were found, whose karyotypes were the same as the parents. In group D, three cases of trisomy 21, three cases of trisomy 18, two cases of extra small chromosome mosaicism and two cases of numerical sex chromosome abnormalities were found. All the mothers in this group were of advanced age. Four cases of structural abnormalities and 22 cases of chromosome polymorphism variations were also found in this group, chromosomal analysis was subsequently performed in those couples, and found that the abnormal chromosomal karyotypes in the fetuses were the same as those in the parents. Conclusions Appropriate prenatal cell genetic diagnostic methods should be chosen according to the causes of abnormal pregnancy history.

Objective To learn students' satisfaction with the general education courses, discuss the problems in comprehensive general education courses in local medical colleges , and provide the basis and reference for the medical general education courses reform. Methods Using the stratified random sampling method, self-designed questionnaire to local medical colleges of 575 different professions stu-dents. The questionnaire had the total of 54 topics whose contents were related to the basic situation aware-ness and satisfaction, the demand for general education courses, general education curriculum problems and suggestions. The survey data were analyzed using SPSS 19.0 software and the results were expressed by the relative number(rate and percentage). The differences between different majors and different grade student satisfaction were analyzed by using rank-sum test, showing statistical significance(P<0.05). Results The total satisfaction was not very high, only 219 students(38%) were satisfied with general curriculum;256 students(45%) thought it didn't matter whether to set general education courses;100 students(17%) were not satisfied. In addition, satisfaction with different grades was undifferentiated (P=0.798), but there was a statistical difference among the students of different professions(P=0.007). Conclusion The general education curriculum of medical schools should not blindly pursue being wide and full. Instead, it should be built from three aspects such as core curriculum, flexible teaching methods, teaching methods reform to enhance teaching effectiveness.

Objective To investigate the clinical characteristics (social background,comorbidity,complications and outcomes of pregnancy) of multipara in Beijing area.Methods A systematic cluster sampling survey was conducted on 15 194 pregnant women who gave birth at 15 hospitals in Beijing from January to June in 2013.The age,gestational weeks at delivery,education background,geographical distribution,health insurance coverage,mode of delivery,comorbidity and complications of pregnancy,pregnant outcomes and other relevant clinical data were collected and analyzed with two-sample t test or Chi-square test.Results The proportion of multipara in Beijing area was 21.12％ (3 209/15 194),the per capita number of delivery was 1.23 (18 745/15 194).The ratio of women with higher education background,average monthly household income over 3 000 yuan,urban residence and social insurance in multipara were much lower than those in primipara (all P＜0.05).The mean maternal age of multipara was (30.02±4.88) years,pre-pregnancy body mass index was 22.24 ± 3.48,which were all higher than those of primipara [(27.82 ± 4.03) years and 21.54 ± 3.29,respectively,t=23.440 and 11.115,all P＜0.01].And the gestational weeks at delivery and mean weight gain during pregnancy of multipara was less than that of primipara [(39.15 ±1.67) vs (39.49 ± 1.67) weeks,t=-14.044,P=0.000;(14.66±6.24) vs (15.81 ± 5.86) kg,t=-9.448,P=0.000],while the levels of total cholesterol,triglyceride and low density lipoprotein-cholesterol and the incidence of macrosomia were significantly higher [(5.59± 1.14) vs (5.24± 1.15) mmol/L,(2.31± 1.38) vs (1.96± 1.34) mmol/L,(3.03±0.91) vs (2.82±0.87) mmol/L,t=12.867,15.718 and 10.275,all P＜0.01;9.29％ (298/3 209) vs 7.24％ (868/11 985),x2=14.926,P=0.000].Significantly lower incidences of abnormal amniotic fluid volume,premature rupture of membranes,fetal distress,abnormal labor and vaginal delivery (all P ＜ 0.01),but higher neonatal birth weight [(3 374.38 ±504.57) vs (3 328.39±488.70) g,t=4.839,P=0.000] and cesarean section rate [45.96％ (1 475/3 209) vs 42.49％(5 092/11 985),x2=12.477,P＜0.01] were found in multipara than in primipara.Compared with primipara,multipara had higher incidence of gestational diabetes mellitus,diabetes during pregnancy,pregnancy complicated with cardiovascular problems,hypertensive disorder complicating pregnancy [adjusted OR(95％CI):1.265 (1.135-1.411),1.799 (1.215 2.663),1.567 (1.221-2.347),1.647 (1.300-2.086),all P＜0.01].Conclusions The primipara is the major reproductive population in Beijing area.However,the multipara requires close antenatal care because of their susceptibility to pregnant complications.