Female ; Humans ; Maternal Health Services ; Maternal Mortality ; Pregnancy

Objective To explore the effects of prenatal infection on the development of lungs by dynamic observation of morphology and numbers of inflammatory cells in lungs of rat pups exposed to antenatal inflammation.Methods Pregnant Wistar rats were randomly divided into experimental group and control group.Pregnant rats of both groups were intraperitoneal injected with either lipopolysaccharide (LPS) 2.5mg/kg or the same volume of normal saline on embryonic day 19 and 20, respectively, and were allowed to term deliver.Onday1, 3, 7, 14, 21and28 (D1, D3, D7, D14, D21 andD28), eight pups of each group were killed by 10％ chloral hydrate (1ml/kg) and lungs were collected.The numbers of myeloperoxidase (MPO) and CD68 as markers of both neutrophils and macrophages were counted.Morphometric assessments were performed by measuring the mean numbers of alveolar, the mean ratio of alveolar surface area to per tissue and the mean thickness of alveolar septum.Results With the increasing of postnatal days, the mean numbers of alveolar and the mean ratio of alveolar surface area to per tissue in both groups increased.The mean thickness of alveolar septum got thinner and the numbers of inflammatory cells decreased.On D1, D3, D7 and D14, the mean alveolar numbers of the experimental group (88, 89, 102 and 127 /mm2) were significantly less than those of the control group (105, 109, 123, 156/mm2), P =0.024, 0.009, 0.013, 0.004, respectively.On D1, D3 and D7, the mean ratios of alveolar surface area to per tissue were significantly larger (0.552,0.603 and0.533) than those of control group (0.478, 0.485 and 0.404), P=0.003, 0.001, 0.000, respectively.On D1 and D3, the alveolar septum thickness was significantly thinner (12.30 and 10.75 μm) thanthatin control group (17.13 and 16.13 μm), P=0.000, 0.000, respectively.On D1, D3, D7 and D14, the mean numbers of neutrophils of the experimental group (681, 582, 393 and 379/mm2) were significantly more than those of control group (164, 211, 145 and 179 /mm2), P =0.000, 0.000, 0.000,0.003, respectively.On D1, D3 and D7, the mean numbers of macrophages (613, 578 and 337 /mm2)were significantly more than those of control group (170, 182 and 127, /mm2) , P=0.000, 0.000, 0.000,respectively.Conclusion Prenatal infection results in larger and fewer alveolars and more inflammatory cells in lungs of rat pups.With the increasing of postnatal days, the alveolar morphology was similar to the controis.

Objective To compare the effects of total intravenous anesthesia or Intravenous-in-halation combined anesthesia on intraoperative somatosensory evoked potential (SSEP)and motor evoked potential (MEP)in spinal surgery.Methods Sixty patients scheduled for spinal surgery under general anesthesia were divided randomly and equally into 2 groups.The anesthesia was maintained with TCI propofol (plasma target concentration 3.0-3.5 μg/ml)and 1% sevoflurane+propofol in group T or group I respectively.BIS was monitored and maintained at 40-50.SSEP and MEP was re-corded before induction of anaesthesia (T0 ),5 minutes after tracheal intubation (T1 ),during skin in-cision (T2 )and at the time of decompressing spinal canal (T3 ).Results The latency of P38 and N45 prolonged,and the amplitudes of P38 and N45 was significantly depressed at T1-T3 compared to those at T0 (P <0.05).No statistically significant differences in cortical SSEP amplitudes or latency was observed in each time point.There was no case who could not detect the wave of MEP intraoperative-ly in this study.Conclusion The data from these cases indicates that 1% sevoflurane can be used in conjunction with SSEP and MEP monitoring for some adult patients undergoing spinal surgery.

Background Congenital cataract is the major cause of blindness in children with plentiful clinical manifestations and closely linked with genetics. Objective Present study was to investigate the classification of congenital cataract in Yunnan province.Methods The manifestation characteristics of 184 eyes of 116 patients with congenital cataract in Yunnan province were analyzed.The relationship of performance of various types of congenital cataract between phenotype and hereditary feature were explored. Results All of the 116 congenital cataract eyes from 116 patients were divided into ten types based on the clinical appearance,including the complete cataract,nuclear cataract,posterior polar cataract,anterior polar cataract,coralliform cataract,coronary cataract,pulverulent cataracts,lamellar cataract and blue cataract.Bilateral nuclear cataract and unilateral entire cataract is most prevalent in these patients.Blue cataract and coralliform cataract belong to the less types.Forty-four in 116 cases were found to have the hereditary history and determined as autosomal dominant inheritance.Sporadic cases were determined in 72 cases.Conclusions The analysis of phenotype of the hereditary congenital cataract offers some clues to the classification of congenital cataract.

Objective To understand change and pathogenesis of microalbuminuria(MAU) in cases of adiposity.Method MAU were measured by immunoturbidmetric methods 300 cases of adiposity and 100 cases of nomal children in morning,meanwhile blood press,blood su-gar,blood fat,blood insulin were measured.Results MAU was higher in cases of middle and severe adiposity than normal controls.The diffe-rence was significant(Pa

Objective To investigate the influence of Batroxobin on plasma level of lysophosphatidic acid(LPA) in patients with acute cerebral infarction.Methods A total of 61 patients with acute cerebral infarction were selecued randomly to Batroxobin group ( n=31) or control group ( n=30). Aspirin and Danshen root were used in both groups as basic treatment. Batroxobin was used in Batroxobin group for one course of treatment. The plasma levels of LPA were measured before treatment and 5th, 7th, 10th, and 14th day after treatment in both acute cerebral infraction groups, and compared with health volunteers(normal group).Results The plasma levels of LPA in both Batroxobin group and control group were remarkably higher than that in normal group(all P0.05). In Batroxobin group the plasma levels of LPA were significantly lower than that in control group at 5th, 7th, 10th, 14th day after treatment(all P

Objective To discuss the management of anesthesia for video-assisted laser operation under rigid bronchoscopy.Methods A retrospective review was made on anesthetic records of 15 cases of video-assisted operation under rigid laser bronchoscopy in this hospital from September 2002 to December 2006.According to the ASA classification,there were 7 cases of class Ⅱ,7 cases of class Ⅲ,and 1 case of class Ⅳ.The diagnosis included 13 cases of tumor and 2 cases of cicatricial stricture.All the patients had a forced expiratory volume in 1 second(FEV1) predicted lower than 70%. By using intravenous fast induction,the propofol,fentanyl,and vecuronium or rocuronium were injected successively.Then a rigid bronchoscope was inserted into the trachea under orthoptic laryngoscope.During the operation a total intravenous anesthesia(TIVA) was maintained.Before induction and 5～10 min after operation,we monitored artery blood gas(ABG) levels.Immediately following the operation the end-tidal CO2 pressure(PETCO2) was measured.Results Hemodynamics parameters were not significantly different between preoperatively and intraoperatively.During the operation,the pH value was 45 mm Hg in 5.All the patients presented normal blood pressures and heart rates. Conclusions During video-assisted laser operation under rigid bronchoscope,anesthesia with normal frequency jet-ventilation and artery blood gas monitoring is safe and reliable.

Objective To explore the CT and MRI manifestations and diagnosis of primary small intestinal lymphoma( PSIL) .Methods The CT or MRI in 28 cases of PSIL confirmed by surgical pathology were retrospectively analyzed.Results 28 PSIL patients were confirmed to be non-hodgkin's lymphoma,17 cases were found in terminal ileum or ileocecal junction,11 cases were found in jejunum,near and the middle ileum.All had different degree of bowel wall thickening;CT scan displayed soft tissue density,contrast enhanced CT images demonstrated mild-to-moderate enhancement,uniform enhancement;PSIL was manifested as thick intestinal wall or a mass with slightly hypointensity signal on T1 weighted image,hyperintensity on T2 weighted images,hyperintensity on DWI images and mild to moderate homogeneous enhancement on contrast enhanced T1 weighted images.12 cases of aneurismal dilatation;manifestations were irregular round thickening of intestinal wall with infiltration with expansive;10 cases of infiltrating type,mainly for bowel wall thickening;6 cases of polypoid mass type,density of soft tissue mass,stenosis lumen.Conclusion CT and MRI has obvious advantages in the diagnosis of PSIL, plays an important role in the diagnosis and differential diagnosis.

Objective To assess the role of intervention of dexmedetomidine in lung tissue and plasma of septic rats induced by lipolysaccharide.Methods Forty SD rats weighing 250-300 g were divided into 4 groups:control group (n =10)with saline (1 ml·kg-1·h-1 )infused through the tail veins of rats for 6 h;dexmedetomidine (DEX)group (n =10)with dexmedetomidine,injected 6.5 μg ·kg-1·h-1 for 10 min followed by 5 μg·kg-1·h-1 ,continuously infused through tail veins for 6 h;li-polysaccharide (LPS)group (n = 10 )with lipolysaccharide (7.5 mg/kg)infused through the tail veins of rats;LPS+DEX group (n =10),after infusion of LPS,rats were treated with dexmedeto-midine (bolus 6.5 μg·kg-1·h-1 ,10 min;5 μg·kg-1·h-1 ,continuous infusion)through the tail veins for 6 h.ELISA and Western blot were performed to assess the protein expression of IL-1,IL-6, TNF-αand TLR4;the wet/dry ratio (W/D)of lung tissue in each group was measured and the injury scores were recorded through the Murakami method.Results There was no statistical significance between the control group and DEX group in plasma level of inflammatory factors,pulmonary TLR4 expression,wet/dry ratio and injury score of lung tissues,however,compared to the control group, there was a significant elevation in the above-mentioned biomarkers,W/D and injury score of lung tis-sue (P <0.01).Compared to the control group,there was no statistical significance in the LPS+DEX group.Compared to the LPS+DEX group,the biomarkers mentioned above,W/D and injury score of lung tissues were significantly elevated in the LPS group (P <0.01).Conclusion The irrita-tion of LPS can trigger the elevation of inflammatory factors in plasma,TLR4 expression in lung tis-sues in rats,while the intervention of dexmedetomidine can significantly alleviate this tendency. Dexmedetomidine can suppress the inflammatory reaction and pulmonary edema in septic rats.

Widely accepted in other countries,DRG payment is also referred to in China now and then.The authors reviewed the status quo of medical payment in China,as well as the practices and studies of DRG payment overseas.Based on such studies,the paper probed into the feasibility of DRG application in China,in terms of policy environment,application demand,research basis and technical conditions.Proposed in the paper are ranges of application,possible roadblocks and countermeasures for the application in China,aiming to promote the research,application and use of the method in China.