Objective To study the relationship between matrix metalloproteinase-9 in syncytiotrophoblast and placenta pathological change of fetal growth restriction. Methods The placental samples were collected from 30 patients with FGR and 30 normal pregnant women who delivered in our hospital from January 2001 to September 2001. The tissue sections were dealt with HE stain and PAS stain and then observed by microscope to find the morphological change. 5 another samples from each group were observed by 500H model electron microscope. Immunohistochemical analysis was employed to demonstrate the positive expression of the MMP-9 in syncytiotrophoblast of FGR placenta. Results There are significantly pathological change in 22 placentas of FGR and abnormal rate is 73.33%. The count of stroma fibrosis and fibrinoid necrosis of villi(63.3%), villous vascular decrease and gore(70.0%), villous syncytial knots(43.3%), cytotrophoblasts increase(50.0%) were more significant in the placenta of FGR group than that of normal group(6.7%,10.0%,3.3%,13.3%)(P

Objective To investigate the role of vascular cell adhesion molecule 1 (VCAM 1) in pathogenesis of pregnancy induced hypertension (PIH) complicated by fetal growth restriction (FGR). Methods The placenta samples were collected from 30 pregnant women with PIH complicated by FGR, 28 FGR patients without PIH and 30 normal pregnant women. Immunohistochemical analysis was used to demonstrate the positive expression of VCAM 1 in placenta vascular endothelium and syncytiotrophoblast of these samples. Results In placentas of PIH complicated by FGR (80%),expression of VCAM 1 in the decidual vascular endothelium was significantly higher than those without PIH (25%) and normal placentas (15%)( P

Objective To investigate the efficacy of heparin plus low-dose aspirin on pregnant women with primary antiphospholipid syndrome(APS). Methods Three hundred and twenty women with unexplained pregnant failure were reviewed and anticardiolipin (aCL) immunoglobulin antibody G and M were tested. Heparin plus low-dose aspirin was given to 36 women with positive results. Results One fetal death and one embryo loss occured. The live birth rate was 94.4%(34/36) and the mean gestational week was (35.7?3.2) wks. The average birth weight was (2960?458) g which was significantly higher than the normal pregnancies (2684?324)g ( P

Objective To determine the effects of two fluid resuscitation strategies on the changes of hemodynamic variables,serum concentration of tumor necrosis factor-alpha(TNF-α)and interleukin-6 (IL-6)in a clinically relevant model of uncontrolled hemorrhagic shock in pregnant rabbits.Methods Hemorrhagic shock was induced by bleeding via carotied artery,followed by transection of a medium vessel in gestational sac.Experimental design consisted of three phases,shock phase(0-30 min),prehospital phase(30-90 min)and hospital phase(90-180 min).Twenty pregnant rabbits were randomly divided into two groups(n=10/group),aggressive fluid resuscitation group(PNL group)and limited volume resuscitation group(PLH group).In the shock phase,animals were hemorrhaged by blood withdrawal to mean arterial pressure(MAP)of 40-45 mm Hg(1 mm Hg=0.133 kPa)via carotid artery.In the prehospital phase,a medium vessel in the gestational sac was transected,then the animals in the PNL group and PLH group were resuscitated with 0.9% normal saline(NS)and shed blood to MAP of 80,60 mm Hg respectively.In the hospital phase,bleeding was controlled by surgical intervention and all the animals were reinfused with shed blood and NS to MAP 80 mm Hg.Hemodvnamic variables and respiration rate were monitored and blood samples were collected for TNF-α and IL-6 measurement.and finally subsequent volume resuscitation and survival rate were recorded.Results (1)At 120 min,the respiration rate and heart rate in the animals assigned to PLH group was(66±16)bpm,(235±41)bpm respectively,which were significantly lower than those in PNL group(P＜0.01),while MAP and central venous pressure in the PLH group was(80.4±7.2)mm Hg,(8.0±4.4)cm H2O,respectively,which were significantly higher than those in PNL group(P＜0.01);(2)The serum concentration of TNF-α,IL-6 of all the animals were markedly increased after hemorrhagic shock.and peak at 24 min.The serum concentration of TNF-α,IL-6 in animals assigned to PLH group were(105±67)ng/L,(118±51)ng/L respectively,which were significantly lower than those in PNL group(P＜0.01).The serum concentration of TNF-α,IL-6 in the animals assigned to PLH group were decreased to normal at 480 min;(3)The subsequent blood transfusion volume and NS resuscitation volume in PLH group in prehospital phase were(16.0±2.2)ml,(39.0±5.5)ml respectively,while those in hospital phase were(28.0±6.7)ml,(90.0±7.1)ml respectively,which were significantly lower than those in PNL group(P＜0.05);(4)The 24 and 72 hours survival rate in the animals assigned to PLH group were 100%,90% respectively;which were significantly higher than those in PNL group(P＜0.01).Conclusion Limited volume resuscitation improves thermodynamic changes of pregnant rabbit,attenuates the increase of serum concentration of TNF-α,IL-6,and results in higher survival rate.Limited volume resuscitation is an ideal means for hemorrhagic shock resuscitation in pregnant rabbit.

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 study the changes of Prealbumin (PA),C-reactive protein (CRP) and D-dimer (DD) levels in septic shock patients due to pneumonia so as to explore the relation to the severity of disease and prognosis.Methods PA,CRP and DD levels of 48 sepsis patients were measured on 1st 、 3rd、5th day after admission and the last day before discharge or death.Meanwhile APACHE Ⅱ score were documented.According to prognosis,patients were divided into death group and non-death group.Results The levels of PA、CRP and DD on the 1 st day were of no significant difference between the death group and non-death group( t = 2.315 ,P ＞ 0.05;t =2.013,P ＞0.05; t =2.511 ,P ＞0.05).The level of PA in death group on the 3rd day,the 5th day and the last day was much lower than that in non-death group ( t = 2.422,P ＜ 0.05; t = 2.557,P ＜ 0.05; t = 2.906,P ＜ 0.05 ).The level of CRP and DD in death group on the 3rd day,the 5th day and the last day was much higher than those in nondeath group(t =2.061 ,P ＜0.05 ;t =2.843,P ＜0.05 ,t =3.519,P ＜0.01 and t = 2.576,P ＜0.05,t = 2.823,P ＜0.05; t = 3.371 ,P ＜ 0.01 ).There was a negative correlation between PA and APACHE Ⅱ scores ( r = - 0.631,P ＜0.01 ) ,while a positive correlation was found between CRP,DD and APACHE Ⅱ score(r =0.687 ,P ＜0.01 and r =0.651 ,P ＜ 0.01 ).Conclusions Persistent low level of PA and high level of CRP,DD indicated severe disease course and unflavored prognosis.It is of clinical value to evaluate the severity of disease and predict prognosis in sepsis by combined dynamic observation of PA,CRP and DD levels.

Objective The purpose of this study was to explore the expression of human fibrinogen-like protein 2 (hFgl2) in patients with cryptococcal meningitis (CM).Methods The expression of hFgl2 in the peripheral blood leukocytes from 20 CM cases and 20 healthy individuals,and the expression of hFgl2 in cerebrospinal fluid (CSF) leukocytes in 11 pairs of CM patients and matched controls was detected using immunohistochemical methods.Medical image analysis system (MIAS) was used to analyze the expression of hFgl2 gray values,which were negatively correlated to the expression of hFgl2 protein in both peripheral blood and CSF.Results The average gray values for hFgl2 protein in peripheral monocytes of CM patients and healthy controls were 114.49± 11.82 and 137.56± 10.64,respectively,and those in peripheral neutrophils were 111.71 ± 8.62 and 143.56±12.57,respectively.Compared with the healthy control group,expressions of hFgl2 in peripheral blood monocytes and neutrophils were both significantly increased in CM patients (t =21.21,t=27.19; P＜0.01).The average gray values for hFgl2 protein in CSF monocytes from CM patients and negative controls were 115.44±8.67 and 149.25±8.57,respectively,and those in CSFneutrophils were 111.71±8.62 and 143.56 ± 12.57,respectively.The expressions of hFgl2 in CSFmonocytes and neutrophils were significantly increased in CM patients (t =29.95,t=28.87; P＜0.01),while the expression intensity of hFgl2 was similar when peripheral blood monocytes and neutrophils compared with their CSF counterparts (t=0.924,t=0.607; both P＞0.05).Conclusions hFgl2 can be expressed in both peripheral and CSF monocytes and neutrophils in CM patients.

0.05).Different work environments showed a specific influence on the percentage of CD3+,CD3+CD4+,CD3+CD8+ and CD3-CD19+ cells.When the naval personnel were divided into A,B and C groups according to extent of exposure to electromagnetic radiation(A

85%of IRAB were resistant to the rest 12 antibacterials except polymyxin B,cefoperazone/sulbactam and minocycline.CONCLUSIONS It should be exactly detect and control IRAB due to extremely severity about hospital infections and multidrug resistantce.

Objective To study the effects of Tripterygium Hypoglaucum Hutch(THH) and its extract(THW-4) on neointimal formation of rabbit carotid arteries after balloon angioplasty.Methods After injury of the common carotid arteries was set up by balloon angioplasty,the rabbits were divided into 3 groups and were given different treatment protocol including gastrogarage of THH(n=9),associated gastrogavage of THH with local administration of THW-4 into the injured arteries(n=9) and 0.25% DMSO saline local administration as the control(n=9).Neointimal fomation was evaluated on days after the procedure by proliferating all nuclear antigen(PCNA) and Evans Blue staining,and quantitative histomorphometric analysis was performed on 28 days.Results The PCNA-positive index in the neointima at day 14 after the procedure was reduced in the THH gastrogavage group and the THH/THW-4 group compared with the control(17.68%?5.27%,6.60%?2.52% vs 40.37%?7.12%,P