Objective: To investigate the efficacy of progesterone tablets in the patients with unexplained recurrent spontaneous abortion and the influence on cellular immunity factor.Methods: Totally 90 cases of unexplained recurrent spontaneous abortion patients were randomly divided into the observation group and the control group (45 ones in each).After pregnancy, the control group was given intramuscular injection of human chorionic gonadotropin, and the observation group started to be treated with progesterone tablets on the 35th day after menolipsis.The levels of interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-17 (IL-17) and IFN-γ were determined, and the expression of T helper lymphocytes (Th17/CD4+), regulatory T lymphocytes (Treg/CD4+) and T helper lymphocytes regulatory T lymphocytes (Th17/Treg) was compared before and after the treatment.The pregnancy success rate and abortion rate were compared between the groups after the treatment, and adverse reactions were also observed.Results: After the treatment, the expression levels of IL-4 and IL-10 in the observation group were higher than those in the control group, and the expression levels of IL-17 in the observation group was lower than that in the control group, and the differences between the groups were significant (P＜0.05);after the treatment, the expression of Th17/CD4+ and Th17/Treg in the two groups decreased, and that in the observation group was lower than that in the control group;after the treatment, the expression of Treg/CD4+ in the two groups increased, and that in the observation group was higher than that in the control group, and the difference was significant (P＜0.05);after the treatment, the expression of IFN-γ in the two groups decreased, and that in the observation group was lower than that in the control group;after the treatment, the pregnancy rate in the observation group was higher than that in the control group with lower abortion rate, and the differences were statistically significant (P＜0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P＜0.05).Conclusion: Progesterone tablets in the treatment of unexplained recurrent abortion patients show significant effects, and can effectively improve the cellular immune factor in the patients, which is worth promoted application in clinics.

2-Amino-3-hydroxylpyridinE-H2O2-horseradish peroxidase (HRP) voltammetric enzymE-linked immunoassay based on N-heterocyclic substrate has been successfully applied for the detection of carcionembryonic antigen(CEA) in human serum. 2-Amino-3-hydroxylpyridine is oxidized with H2O2 catalyzed by HRP, and the resulting electroactive product produces a sensitive voltammetric peak at the potential of 0.36 V(vs. SCE) in Britton-Robinson (B-R) buffer solution. By this voltammetric peak, free HRP can be measured and immunoassay of HRP label can be developed. The enzymE-catalyzed reaction conditions and voltammetric detection conditions have been optimized, and the electrode procedure of the enzymatic product was investigated. The selected optimum reaction conditions were that the reaction medium was pH 6.0 B-R buffer solution for 10 mL reaction solution containing 1.0 mL of 0.2 mol/L B-R buffer solution, 3.0 mL of 8.0 mmol/L 2-amino-3-hydroxylpyridine solution and 1.5 mL of 0.5 mmol/L H2O2 solution, and the reaction time was 30 min at 37 ℃. The optimum detection conditions were that the supporting electrolyte was pH 7.0 B-R buffer solution for 10 mL of the overall detection solution containing 5 mL of reaction solution and 1.0 mL of 0.2 mol/L B-R buffer solution. The optimum instrumental conditions for the detection were chosen as follows: the initial potential, 0.00 V; the final potential, -0.80 V; the potential scanning rate, 400 mV/s; the mercury drop standing time, 7 s. Under the optimum conditions, the linear range for detection of free HRP was 4.0×10-4-1.0 μg/L with a detection limit of 0.12 μg/L. Based on the new immunoassay system, the linear range of the detection to CEA was 0.50-80 μg/L and the detection limit was 0.50 μg/L, which is 10 times lower than that of traditional spectrophotometric enzymE-linked immunosorbent assay method. The 2-Amino-3-hydroxylpyridinE-H2O2-HRP voltammetric enzymE-linked immunoassay new system exhibits excellent performance having wider linear range and lower detection limit. The new method is inexpensive and simple. It has a great potential in clinical diagnosis.

The experiences of coronary artery bypass grafting (CABG ) surgery and perioperative management for critical patients are reported. Forty-five critical CAD patients aged from 41 to 78 years old with 32 male and 13 female underwent CABG.The critical conditions included coronary artery disease complicated with left ventricular dysfunction (LVEF less than 30%) in 7 patients, heart valve disease in 13, postinfarction giant LV aneurysm in 6, aged 75 years or older patients with hypertension, diabetes, and renal or severe lung dysfunction in 8, and emergent CABG because of insufficient blood supply from left coronary artery during cardiac valve replacement or ascending aortic aneurysm operation in 5. Among all the patients, pure CABG was performed in 20, and CABG with other simultaneous procedures in 25. Each of 45 patients received l to 4 bypass grafts with a mean of 2 9. During the early stage of postoperation,there were low cardiac output syndrome in 6 patients, renal failure in 3, pulmonary failure in 2, and MOSF in 1.With the application of IABP, 5 from 6 LCDS patients recovered.Three patients were complicated with renal failure, and they also recovered with the use of peritoneal or blood dialysis postoperatively. During the early stage of postoperation,two patients (4 4%) died of LCOS and MOSF, respectively. One died of arrhythmia 15 months later after operation .The experiences suggest that control of hypertension,heart rate and diabetes before operation, perfect revascularization of ischemic myocardium and effective myocardial protection during operation,prevention of LCOS and renal failure after operation could improve the results of CAD patients undergoing CABG.

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Ventricular Premature Complexes ; therapy

Female ; Humans ; Male ; Sepsis ; complications ; Wernicke Encephalopathy ; diagnosis

Objective To summarize the methods and experiences of aortic arch surgery. Methods In 75 aortic arch operations, 74 were performed by using deep hypothermic circulatory arrest (DHCA), including retrograde cerebral perfusion (RCP) in 54 cases and antegrade selective cerebral perfusion (SCP) in 20 cases. Surgical procedures included ascending aortic and hemiarch grafting in 53 cases, which concomitantly included stent placement intra decending aorta in 11, patching of arch intimal tear in 6 and of decending aortic one in 3. Ascending and total arch grafting in 20 cases,which concomitantly included traditional elephant trunk procedure in 12 and stent placement intra decending aorta in 4. Simple arch aneurysm resection in 1 and arch grafting in 1. Concomitant procedures included Bentall procedure in 17 cases, AVR in 12, Cabrol procedure in 3, mitral valvuloplasty in 5 and aortic valvuloplasty in 9. DHCA time ranged from 9 to 120 min (mean 42.3 min). Results Operative mortality was 6.7%. The most common complications were respiratory insufficiency(11 cases), renal insufficience(7 cases) and temporary mental anomaly(9 cases). Conclusion DHCA+RCP and DHCA+SCP are both effective while the latter is more suitable for complex aortic arch surgery. The choice of surgical procedures depends on the nature of lesion and location of intimal tear. Preoperative condition and surgical technique are the essential factors to success in aortic arch surgery.

Objective:To observe the relationship between diabetic retinopathy (DR) and ? 3 adrenergic receptor (? 3 AR) gene polymorphism in Chinese patients with type 2 diabetes mellitus. Methods: The mutation of genotype of Trp64Arg in ? 3 AR gene was measured wit h PCR RFLP in 50 normal control and 196 patients with type 2 diabetes, while other clinical parameters [body mass index (BMI), blood pressure, fasting blood glucose, serum lipid levels and HbA1c] were all measured. Results: (1)There were no significant differences in the freque ncies of ? 3 AR phenotypes and alleles between type 2 diabetic patients and n ormal controls or between female patients and male patients; (2) The plasma triglyceride, diastolic blood pressure and BMI in female patients with mutation of ? 3 AR gene were higher than those in without mutation. There was no difference in male diabetic patients; (3)There was no difference in genotype frequencies or allele frequencies between diabetic patients with or without retinopathy. Genotype and allele frequencies didnot differ in proliferative diabetic retinopathy and non proliferative diabetic retinopathy. Conclusion: The mutation of Trp64Arg in ? 3 AR gene is associated with obesity, hypertension and dyslipideamia in femal e diabetic patients. Trp64Arg polymorphism in ? 3 AR gene is not associated with diabetic retinopathy in type 2 diabetes mellitus patients in Shanghai.

Child, Preschool ; Female ; Humans ; Multiple Acyl Coenzyme A Dehydrogenase Deficiency ; pathology ; Rett Syndrome ; pathology

Objective To evaluate the immune response triggered by an in-house constructed hu-man metapneumovirus multi-epitope antigen ( MEA) in a mouse model .Methods Female SPF BALB/c mice at age 4-6 weeks were used in the study and divided into 7 groups.Mice in the five groups including MEA+oligodeoxynucleotides containing CpG motifs ( CpG ODN) intraperitoneal injection ( i.p.) treatment group, MEA+Alum i.p.treatment group, MEA+Alum+CpG ODN i.p.treatment group, MEA+CpG ODN intranasal (i.n.) treatment group and MEA+Alum+CpG ODN i.n.treatment group were immunized three times on days 0, 14 and 21, and those in the other experimental group were immunized intramuscularly with MEA+Quickantibody5W on days 0 and 21.A control group without treatment was set up accordingly .All mice were sacrificed two weeks after the last immunization .Antibodies including IgG , IgG1, IgG2a and IgA in serum samples were detected by ELISA .MTS assay was performed to analyze the proliferation of lympho-cytes.The cytotoxicity of cytotoxic T lymphocytes (CTL) was measured by LDH assay.Flow cytometry was used to detect T lymphocyte subsets .The cytokines secreted by T helper cells ( Th1 and Th2) were analyzed with Bio-Rad Liquid Chips.Results High titers of IgG, IgG1 and IgG2a antibodies were produced in MEA treated mice except for those in intranasal treatment groups .Serum samples from three groups including the MEA+Alum i.p., MEA+Alum+CpG ODN i.p.and MEA+Quickantibody5W i.m.treatment groups were positive for IgA antibody .The highest titer of IgA antibody was detected in mice from the MEA+Alum+CpG ODN i.p.treatment group, which was 2.15×103.Compared with the control group, significantly enhanced proliferation of lymphocytes was observed in the MEA+Alum i.p., MEA+Alum+CpG ODN i.p.and MEA+Quickantibody5W i.m.treatment groups (P<0.05).Enhanced cytotoxic activities of CTL were observed in mice with ip.and i.m.treatments as compared with those in control group (P<0.05).The levels of CD4+/CD8+T cells were slightly increased in mice from the MEA+CpG ODN i.p., MEA+Alum+CpG ODN i.p. and MEA+Quickantibody5W i.m.treatment groups as compared with those in control group (P<0.05).In-creased secretion of IL-2, IFN-γand Th2-type cytokines including IL-4, IL-5 and IL-10 were detected in mice from the MEA+CpG ODN i.p.treatment group.The MEA+Alum i.p.treated mice showed a slightly increased secretion of IFN-γand significantly increased secretions of IL-4, IL-5 and IL-10.Significantly in-creased secretions of IFN-γ, IL-4, IL-5 and IL-10 were detected in mice from the MEA+Alum+CpG ODN i.p.treatment group.Significantly increased secretions of IFN-γ, IL-5, IL-10 and granulocyte-macrophage colony-stimulating factor (GM-CSF) were detected in mice from the MEA+Quickantibody5W i.m.treatment group.Conclusion MEA together with different adjuvants could stimulate high titers of specific antibodies , increase the proliferation of lymphocytes and enhance the cytotoxic activities of CTL .CpG ODN could bal-ance the Th1/Th2-mediated immune responses , and the balance could be enhanced when using CpG ODN in combination with Alum .A similar effect could be achieved by using the commercial adjuvant Quickanti -body5w.This study has paved the way for further investigation on the development of hMPV epitope vaccines and diagnostic reagents for hMPV as well as the epidemiological study of hMPV .

Objective To investigate the prevalence rates of healthcare-associated infection (HAI)and antimicrobial use in a hospital in 2011-2013,and provide scientific basis for prevention and control of HAI.Methods HAI prevalence rates and antimicrobial use in a hospital in 2011-2013 were investigated by combination of bedside visiting and medical records reviewing.Results A total of 3 011 patients were investigated during three years,the prevalence rates were 3.49%, 2.87% and 3.98% respectively,difference of prevalence rates during three years were not significantly different (χ2 =2.105,P =0.356).Among HAI sites,lower respiratory tract ranked first,the major pathogens were gram-negative bacil-li,constituent ratios of different pathogens were not significantly different among three years(χ2 =1.003,P =0.972);anti-microbial usage rates and specimen detection rates among 3 years were both significantly different(χ2 =12.569,P <0.01;χ2=6.758,P <0.01,respectively),antimicrobial usage rate was highest in 2011(63.40%),and specimen detection rate was highest in 2012(62.14%).Conclusion Point prevalence rate in this hospital is at average national level,antimicrobial usage rate decreased, the consciousness of pathogenic detection gradually enhanced,clinical application management of antimicrobial agents still needs to be strengthened continuously.