Objective To evaluate the pregnancy outcome of women with pulmonary arterial hypertension (PAH).Methods The medical records of 103 pregnant women with PAH admitted to Beijing Anzhen Hospital from January 2007 to March 2011 were studied retrospectively.Results (1) Degree of PAH and cardiac function.Among the 103 PAH,92 cases were patients with congenital heart disease and 13 cases were with rheumatic heart disease.They were divided by color doppler ultrasound into mild PAH group (34 cases),moderate PAH group (22 cases) and severe PAH group (47 cases).Per heart function classification,21 cases (20.4％,21/103) were class Ⅰ,44 cases (42.7％,44/103) were class Ⅱ,27 cases (26.2％,27/103) were class Ⅲ and 11 cases (10.7％,11/103) were class Ⅳ.More patients were class Ⅲ and Ⅳcardiac function in the severe PAH group than in the mild and moderate PAH groups,with statistically significant difference (P ＜ 0.05).(2) Delivery mode.There were 44 term delivery and 23 preterm birth in the 103 PAH patients.Sixty-three cases (94％,63/67) received cesarean section and 4 cases had vaginal delivery.There were 36 iatrogenic abortion (35.0％,36/103).The iatrogenic abortion rate in the severe PAH group was significantly higher than those in the mild and moderate PAH groups (P ＜ 0.05).(3) Perinatal outcomes.The full-term delivery rates in the mild and moderate PAH groups [80％ (20/25) and 14/17] were significantly higher than the severe PAH group (40％,10/25),respectively (P ＜ 0.05).And the premature birth rate of the severe PAH group(60％,15/25) was significantly higher than the mild and moderate PAH group [20％ (5/25)and 3/17,P ＜ 0.05].There were 4 neonatal asphyxia.The birth weight of mild,moderate and severe PAH groups were (3071 ± 443),(2910 ± 619) and (2381 ±589) g,respectively.The birth weight in the severe PAH group was significantly lower than the mild and moderate PAH groups (P ＜ 0.05).(4) Mortality.Nine cases naternal death happened,with a mortality of 8.7％ (9/103).All of them were severe pulmonary hypertension patients.Conclusions PAH is a serious complication during pregnancy.Women with mild PAH and normal cardiac function could continue pregnancy to full-term.Women with moderate PAH might continue pregnancy to 32 weeks under intensive care,cesarean delivery is preferable.Pregnant women with severe PAH should terminate pregnancy because of the high mortality.

OBJECTIVE: To investigate the bacteria distribution, drug bacterial sensitivity characteristics of the rural chronic rhinosinusitis (CRS). And to explore the effect of antibiotic on pathogenic bacteria culture. METHOD: Choose nasal sinus secretions from 115 CRS patients living in rural areas. Aerobic bacteria culture, anaerobic bacteria culture and drug sensitive test were procedured for each sample. At the same time the use of antibiotics nearly 2 months and nearly 2 weeks were collected. RESULT: Among one hundred and fifteen specimens, 17 kinds of germs were detected in 37 cases, the positive rate of aerobic bacteria was 32.17%. Staphylococcus aureus and epidermis staphylococcus aureus the most common type of aerobe in CRS patients at rural areas. There was negative result in the anaerobic bacteria culture of 17 maxillary sinus specimen. The cases of using antibiotics nearly 2 months was up to 90, accounting for 78.26%. Nearly 2 weeks, 73 cases, accounting for 63.48%. The chi-square analysis showed high bacterial culture rate, in chronic rhinosinusitis with nasal polyps (CRSwNP group), which revealed correlation between bacterial infection factors and nasal polyps formation. For CRS patients with positive result of bacterial culture, they were sensitive to ofloxacin, cefotaxime, organism, ciprofloxacin, magnitude cephalosporin, and were drug fast to penicillin G, ampicillin, erythromycin. CONCLUSION No specific differences was found in the bacteria distribution of rural CRS. antibiotics abusage in rural CRS patients and the anaerobic bacteria culture techniques is the main factor resulting in low culture rate. Rational use of antimicrobial agents should be established on the basis of the bacterial culture and drug sensitive test.
Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bacteriological Techniques ; Chronic Disease ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Rural Population ; Sinusitis ; drug therapy ; microbiology ; Young Adult

Objective To investigate one year survival rate and life quality of patients with non-small cell lung cancer(NSCLC)treated by different arms.Methods One hundred and seventy-nine cases NSCLC patients from January 2013 to December 2014 were selected from the Third Hospital of Tanshan and followed-up,including 57 cases with surgical treatment,70 cases with the use of Navelbine plus cisplatin,52 cases with dendritic cells(DC)and cytokine induced killer cells(CIK)immune based therapy(DC/CIK)treatment.After one year period of radiotherapy and chemotherapy,the SF-36 questionnaire was used to investigate the quality of life of the surviving patients,and the quality of life was assessed from three aspects of the physiological,psychological and social functions.To quantify the quality of life score,the 100 percentage grading system was adopted,logistic regression analysis was used to adjust the influence of age and gender on survival rate,and the data were analyzed by SAS 9.2 statistical software package.Results One hundred and seventy-nine subjects were included in this study,by the end of follow-up on December 2015,there were 119 cases survived,the survival rate was 66.5％(119/179).Survival rate of surgical operation group,DC/CIK group and chemotherapy group orderly decreased(82.5％(47/57),76.9％(40/52)and 45.7％(32/70),P＜0.01).After adjusting age and gender impact,multiple logistic regression model showed that DC/CIK group survival rate was 3.96 times higher than the pure chemotherapy group(95％CI=1.78-8.80),surgical operation group was 5.58 times higher than simple chemotherapy group(95％CI=2.44-12.79).There were no significant differences between DC/CIK group and surgical operation group on physical disease,health status,emotional intelligence,mental health and social function,no significant difference(P＞0.05),but the chemotherapy group was lower(P＜0.05);physiological function in the chemotherapy group,operation group and DC/CIK group showed an increasing trend(P＜0.05).Conclusion The one year survival rate of NSCLC patients treated by different arms is 66.5％,and the life quality of patients with biological immune therapy method is better.

AIM: To investigate the effect of oral clarithromycin on serum concentrations of aminophylline at steady state and its pharmacokinetics in New Zealand rabbits. METHODS: The serum concentration of aminophylline was determined by FPIA in rabbits given(po) aminophylline or aminophylline combined with clarithomycin. The experiment was divided into 2 stages: (Ⅰ)the subjects only received a four day course of oral aminophylline until steady state;(Ⅱ)aminophylline and clarithromycin were coadministrated from the d 5 to d 10. The dose of aminophylline was 30 mg?kg -1 and the dose of clarithromycin was 50 mg?kg -1 for each rabbit. The two series of pharmacokineticis parameters were tested by statistic analysis. RESAULTS: There was no significant variation in pharmacokinetic parameters between two stages. CONCLUSION: It is not necessary to change the therapeutic dose of aminophylline when the drug is taken in combination with clarithromycin.

Objective To discusses the value of combined CA125 and CT/MR/ in diagnosing the ovarian thecoma.Methods Forty cases of patients with ovarian thecoma were retrospectively analyzed.The results of CA125 and the appearance of CT and MRI were recorded,the value of CA125 changes and CT/MRI features was analysed in the diagnosis of ovarian thecoma.Results The value of CA125 elevated in 17 cases of ovarian thecoma,and showed statistical significance in the ratio((12/35 vs.5/5;x2=2.274,P=0.046) and the levels of the value of CA125 ((90.24 ± 18.56) U/ml vs.(243.35 ± 20.45) U/ml;t =7.780,P =0.002).Compared with 40 cases of control group,elevated CA125 level showed no obviously statistical significance (t =5.348,P=0.22).Forty patients in CT and MRI were all single lesion,30 cases were solid neoplasm,the rest were cystic-solidary lesions or priority of cystic component,75％ lesions were more than 5 cm,9 cases of lesions contains calcification.In pre-enhanced CT and MR/scan the lesions showed iso-density or signal-intensity,mildly enhanced;Twenty-two patients with ascites and 11 cases with symptoms in the elevating of estrogen.Combined the results of CA125 and the apperaance of CT and MR/,the accuracy of the diagnosis in ovarian thecoma was 85％.Conclusion CT and MR/imaging combining with CA125 can improve the diagnosis accuracy of ovarian thecoma.which should be given priorities.

Objective To explored the effect of sildenafil in treatment of pregnant women with pulmonary arterial hypertension.Methods From January 2012 to November 2013,64 pregnant women with pulmonary arterial hypertension (PAH) were randomly divided into group and control group.Control group:16 cases with mild and 16 cases with moderate PAH.To treatment with low-flow oxygen,low-salt diet therapy,cardiac,etc.sildenafil group:15 cases were mild pulmonary hypertension,and 17 cases moderate PAH.Treatment sildenafil 25 mg,rid in this study.Then the variation of the blood oxygen saturation,pulmonary artery systolic pressure,hemodynamic parameters and pregnancy outcome,including delivery modes,neonatal weight,morbidity of mother and fetus were compared.Results (1) Cardiac function and pulmonary hypertension:control group:the proportion of cardiac functional class Ⅰ-Ⅱ reduced from 81％ (26/32) to 56％ (18/32) significantly after treatment (P ＜ 0.05).Sildenafil group:the proportion of cardiac functional class Ⅰ-Ⅱ increased from 75％ (24/32) to 84％ (27/32) significantly after treatment (P ＜ 0.05).Between two groups,the proportion of mild and moderate turning to server PAH patients were significant differentce (P ＜ 0.05).(2) The pregnancy outcome of two group:the premature birth rate,low birth weight rate and cesarean section rate of 9％ (3/32),9％ (3/32)and 69％ (22/32)in sildenafil group were significantly lower than 16％ (5/32),19％ (6/32) and 81％ (26/32) in control group (P ＜0.05).The rate of vaginal delivery,term pregnancy and neonatal weight of 31％ (10/32),91％ (29/32) and (3 214 ±306) g in sildenafil group were different with 19％ (6/32),84％ (27/32) and (3 004 ±458) g in control group (P ＜ 0.05).(3) Hemodynamic parameters:in control group,arterial partial pressure of oxygen,oxygen saturation and left ventricular ejection fraction,pulmonary systolic pression were (80 ± 5) ％ to (72 ±8)％,(87 ±8) to(83±9) mmHg(1 mmHg=0.133 kPa),0.77 ±0.24 to 0.70 ±0.38 and (63 ±9) to (69 ± 12) mmHg before and after treatment,which showed remarkable decreased trends(P ＜ 0.05).The other parameter were not significantly different (P ＞ 0.05).In sildenafil group,arterial partial pressure of oxygen,oxygen saturation and left ventricular ejection fraction,pulmonary systolic pression showed increased trend before and after treatment,which were (80 ± 9) ％ to (88 ± 9) ％,(84 ± 3) to (89 ± 7) mmHg,0.70 ± 0.32 to 0.79 ± 0.27 (P ＜ 0.05),in the mean time,pulmonary systolic pression showed decreased trend from (65 ± 18) to (60 ± 13) mmHg (P ＜0.05).The other parameter did not show significant different (P ＞ 0.05).Conclusions Sildenafil treatment can significantly improve the clinical symptoms,cardiac function and hemodynamic parameters.It also could significantly improve pregnancy outcomes,reduce premature delivery,the incidence of low birth weight children,and cesarean section rate.

Objective: To optimize the extraction process for Semen Strychni and Ephedra Sinica in Jiufen Powder. Methods: To determine the content of strychnine, brucine and ephedrine in extract solution by orthogonal design and TLC. Results: The volume of solvent and the number of times of extration have notable effect for extraction. The best conditions are 10 times of the herb quantity of water, extract three times, 1 hour per time.

Objective To discuss the early stage treatment of reduction and the curative effect in coxa dislo- cation with acetabular fracture. Methods According to the different type of coxa dislocation with aeetsbular frac- ture,22 patients were given the distinctive operation and drawn reduction. As to 22 cases combination with acetabu- lar fracture and basis of difference type of the fracture were selected the method of suitable operative entrance or in- ner fixation. In this gronp,22 patients were followed up about 6 month to 3 years(average 15.3 months) after opera- tion. According to the standard of America orthopedic surgery study were commented on curative effect. Results Excellent 15 cases,well 4 casea,pass 2 cases,bad 1 case. Total fine rate were 86% .Conclusion Each kinds type of the hip dislocation cases should needed emergency reduction. The operation treatments were selected first method to settlement the bone shatter displacement in acetabular fracture or unsuitable joint and unsteady joint.

Objective To analyze the changes of leptin and adiponectin levels in serum of patients with diabetic retinopathy and investigate their chnical significance in diabetic retinopathy (DR).Methods One hundred and twenty-one patients with type 2 diabetes mellitus as the case group who hospitalized from Nov.2012 to Nov.2013.Among the patients,41 cases of non-DR,40 cases of nonproliferative-DR,40 cases of proliferativeDR.Forty healthy were served as the control group.The levels of leptin and adiponectin in serum were detected by Enzyme-Linked Immuno Sorbent Assay (ELISA).Results The overall levels of leptin in case group was (15.25 ± 4.70) μg/L,significantly higher than the control group ((6.15 ± 1.70) μg/L; t =-11.696,P ＜0.01)).The level of adiponectin in case group was (7.39 ± 1.92) mg/L,lower than the control group ((11.10 ± 1.46) mg/L; t =11.216,P ＜ 0.01).Moreover,the levels of leptin increased successively from (10.91 ±1.21) μg/L in NDR,(15.22 ±3.75) μg/ L in NPDR and (20.50 ±3.70) μg/L in PDR.While,the adiponectin levels decreased from (9.61 ± 1.35) mg/L in NDR,(7.11 ± 1.18) mg/L in NPDR and (5.34 ± 1.36) mg/L in PDR respectively.And the differences between the groups were significant(F =149,542,291,550;P ＜0.05).The levels of leptin and adiponectin in serum showed a negative correlation (r =-0.662,P ＜0.01).Condusion Levels of leptin and adiponectin in serum associate with DR,and both of them might be the important indexes for the prediction and curative effect evaluation of DR.

Purpose To study the clinicopathologic features of inflammatory myofibroblastic tumor (IMT) of long bone.Methods HE and immunohistochemistry of EnVision two-step were used to observe the clinical,radiological,histological and immunophenotype features of IMT of bone.The literatures were reviewed.Results 4 cases of IMT of bone were respectively located in the tibia (2 cases) and femur (2 cases).Histologically,the lesions were characterized by collagen-rich and spindled to plump myofibroblast-like cells and a variable admixture of inflammatory cells.Immunohistochemical study showed that the vimentin,SMA,actin,H-caldesmon and CD34 were positive.Conclusion The IMT is a rare and locally aggressive tumor.The diagnosis should combine the histological characters with immunohistochemical results and should be differentiated from the other tumors and tumor-like lesions.