Cardiovascular Diseases ; Humans ; Mast Cells

Biomarkers, Tumor ; metabolism ; Carcinoma, Small Cell ; genetics ; metabolism ; pathology ; Carcinoma, Squamous Cell ; pathology ; Chromosome Aberrations ; Diagnosis, Differential ; Humans ; Keratins ; metabolism ; Lymphoma ; pathology ; Mucin-1 ; metabolism ; Urinary Bladder ; pathology ; Urinary Bladder Neoplasms ; genetics ; metabolism ; pathology

Objective To investigate the clinical features,critical laboratory parameters,and fetal monitoring methods in intrahepatic cholestasis of pregnancy(ICP).Methods A retrospective analysis of 21 cases of ICP suffered with fetal death in Women's hospital.School of Medicine.Zhejiang University from January 1999 to December 2010 were discussed.Results(1)The average age of ICP patients suffered with fetal death were(30.2±4.6)years old.Among them,4 cases were older than 35 years,six cases were multipara.oneo of them suffered stillbirth 2 year before.Twenty cases were singleton pregnancies and 1 cage was twin pregnancy.(2)All 21 cases of fetal death occurred in the third trimester,12 cases occurred before 37 weeks,9 cases after 37 weeks.Nine cases were diagnosed by ultrasound in outpatient clinics,fetal heart beat disappeared in 9 patients after admission because of ICP, two disappeared after labor, one during anesthesia before emergent surgery. Perinatal mortality rate of ICP was 0. 148% (21/14 184), and fetal death occurred from 29 to 41 weeks with an average gestational age of ( 33.8 ± 4. 2 ) weeks, ( 3 ) Puritus occurred in all 21 cases while 11 of them had pruritus all over the body. Ten pregnant women felt the fetal movement decreased or disappeared before diagnosis of fetal death. The glycocholic acid levels increased in all of the 21 cases. Among them, glycocholic acid levels in 11 cases were (21.49 -64. 48) μmol/L, while in 10 cases were ≥64. 48 μmol/L Serum bile acid levels elevated in 16 cases which had been analyzed ( the other 5 cases had not been checked ), and the highest level reached 270 μmol/L Serum alanine aminotransferase and aspartate aminotransferase were increased in 14 cases. Seven cases had their total bilirubin ＞21 μmoL/L, and 12 cases had their direct bilirubin levels significantly elevated. Among the 21 cases of ICP, 15 cases were in severe status, while the other 6 cases were mild. (4) Nine patients had no antepartum surveillance since fetal death were diagnosed before admission. The results of antepartum surveillance were as follows: 2 cases had nonreassuring nonstress test (NST), one had mild "V" type deceleration. Absence of diastolic flow in umbilical artery were found in 3 cases, and low fetal biophysical score was got in one case. ( 5 ) All 21 patients had vaginal delivery. Six of them delivered after natural contraction, and the remaining 14 cases delivered after oral intake of mifepristone and amniotic injection of ethacridine, or oxytocin induced labor within 48 hours, only one case delivered after additional dinoprostone suppositories. The appearance of fetus, placentas and membranes were normal, the lengths of umbilical cord were average. Four cases were found with cords binding the necks or the bodies. Eighteen cases had grade Ⅲ amniotic fluid with meconium-stained, and 2 cases complicated by oligohydramnios. Ten cases had their fetuses and placentas examined by pathologist. Among them, one case had multiple malformations, no more obvious pathological abnormalities were found in other fetuses. Pathologic examination showed that fibrin deposited around chorion and deciduas basalis, large vessels accompanied by calcification, degeneration,hemorrhagic infarction, and increased focal syncytial nodules could be seen in all of the ten placentas. Conclusions Fetal death in pregnant women with ICP of ten occurs after the contractions, Severe ICP may be a key factor that involved in the occurrence of fetal death. Up to now, there is no valid indicators in fetal monitoring, which can predict fetal death. Extensive assessment of the severity and careful antepartum surveillance should be achieved before timely termination of pregnancy.

Aged ; Anthracosis ; complications ; pathology ; Bronchoscopy ; Fiber Optic Technology ; Humans ; Lung Diseases, Obstructive ; etiology ; pathology ; Male ; Pneumonia ; etiology ; pathology ; Retrospective Studies

ObjectiveTo study the necessity of treating prolapse of lumbar intervertebral disc by active movement treatment. Methods68 patients with prolapse of lumbar intervertebral disc were divided into the group of active movement treatment (31 cases) and the control group (37 cases). One year later, the recurrence rate and F wave motor nerve conduction velocity of two groups were compared. ResultsThere is a lower recurrence rate (P<0.05) and a faster F wave motor nerve conduction velocity (P<0.01) in the group of active movement treatment compared with the control group. F wave motor nerve conduction velocity of the group of active movement treatment is also faster than that of 1 year ago (P<0.001). Conclusions It is necessary for patients with prolapse of lumbar intervertebral disc doing active movement.

Objective To investigate the efficiency,decision of intra-operative puncture route,treatment of perioperative complications and discuss the other relative problems of the treament for lumbar disc herniation with percutaneous transforaminal endoscopic discectomy.Methods To excise the nucleus pulpesus under percutaneous transforaminal endoscopic discectomy,use the Macnab standard,visual analogue scale and infrared thermal imaging to estimate the efficiency.Results Among followed-up of 208 patients,182 patients were excellent and good outcome,23 patients favorable,2 patients fair,0 patient poor.The leg and back VAS was a significant improvement 1 week post-operation compared with pre-operation (P ＜ 0.05),but no statistical difference among 3 months,6 months,12 months and 1 week post-operation (P ＞ 0.05).The infrared thermal imaging point out that the legs skin temperature of D-value was a significant improvement post-operation compared with pre-operation (P ＜ 0.05).Conclusions The method excised the nucleus pulpesus,and provided the spine maximum protection about the stability and flexibility.Intra-operative puncture route of individuation design can reduce the complications of intervertebral foramen perioperative,and the key to improve the effectiveness.

Objective To investigate the biodistribution,excretion and other pharmacokinetics,of 188Re-1-hydroxy-1,1-ethylidene disodium phosphonate (HEDP) in cancer patients with osseous metastases who were suffering form bone pain. Methods A single dose (20,30,40,and 50 MBq/kg,10 patients in every group) of 188Re-HEDP was administered as a bolus injection,meanwhile dynamic images on patient's chest were collected for 30 min. Anterior and posterior whole-body images were obtained at 1,2,4,5,12,24,36,48,60 and 72 h after injection of 188Re-HEDP. By region of interest (ROI) technology,the curve of time-background corrected counts of left cardiac ventricle could be generated,and the background-corrected counts of various organs and total whole body could be calculated as a geometric mean using the anterior and posterior scans,and transformed to the percentage injected dose ( % ID). Urine was collected after injection of 188Re-HEDP. Counts of urine were measured by γ counter. Analysis of variance and t-test were used. Results Linear relationship of metabolism of 188Re-HEDP was observed in the doses from 20 to 50 MBq/kg,with correlation coefficient r2 = 0. 9376. A two-compartment model was the best fit for metabolism of 188Re-HEDP with the parameters median area under curve (AUC) 3.32 × 105,3.97 × 105,7.83 × 105,8.58 ×105,respectively; median α 0.06,0.05,0.04,0.06 respectively; median β 1.16 ×10-3,1.16 × 10-3,1.03 × 10-3,1.15 × 10 -3 respectively; median A 3591.21,4858.23,5642. 48,4167.05 respectively; median B 293.97,352.95,614.41,1063.82 respectively; median T1/2(α) 12.51,12.83,15.41,12.02 min respectively; median T1/2(β) 595.47,596.50,673.09,600.93 min respectively in the doses of 20,30,40and 50 MBq/kg. 188Re-HEDP was taken up mainly by bone up to 40% ID at 4 h. Urine profile showed that 66.79 % ID was eliminated within 24 h,being its 74% collected along the first 5 h after-administration.Conclusions In the doses of 20,30,40 and 50 MBq/kg,metabolism of 188Re-HEDP presented linear model. Pharmacokinetics of 188 Re-HEDP followed a two-compartment model administrated by blood vessel.Following injection,188 Re-HEDP was taken up mainly by bone and excreted by uropoietic system.

Objective To explore the effect of multiple-formed nursing teaching ward-round.Methods Trainings and practices about muhiple-formed nursing teaching ward-round were executed to clinical instruction teachers.Results 95.9%of nursing students were satisfied with the quality of nursing teaching ward-round.After training ang practices,the evaluation to the nursing teaching ward-round and the scores of theoretic and operation examination of nursing students raised significantly(P＜0.05).Conclusions The trainings and practices improve the teachers' ability of utilizing multiple-formed nursing teaching ward-round,which not only enhance the students' study initiative,but also improve the query of nursing teaching teaching ward-round.

AIM: To explore the effect of brain ischemia injury on cell proliferation and nestin expression in cortex and subependymal zone (SEZ). METHODS: Using a local brain ischemia model(MCAO), BrdU positive cells of cortex and subependymal zone (SEZ), also nestin positive cells, were observed by immunohistochemistry. RESULTS: BrdU and nestin positive cells in SEZ of MCAO rats were obviously increased. In cortex, only nestin positive cells were observed. CONCLUSION: Neural stem cells in SEZ and cortex were activated after brain ischemia, it may be related with neural recovery after brain ischemia injury.

Objective To investigate the effects of hyperglycemia on ubiquitination and endoplasmic reticulum stress in renal intrinsic cells (podocytes and proximal tubular epithelial cells)and its role in pathogenesis of diabetic nephropathy.Methods Diabetic mice were induced by streptozotocin injection.After 16 weeks of hyperglycemia,immunofluorescence was used to detect the expressions of ubiquitination and glucose-regulating protein 94 (GRP94) in renal cortex and medulla area of kidney sections.Primary mouse podocyte and proximal tubular epithelial cells were isolated by flow cytometry,and exposed to 30 mmol/L glucose for indicated time (1 d,3 d and 7 d).Their ubiquitination and GRP94 expressions were evaluated by Western blotting.Results Diabetic mice presented microalbuminuria and slightly widened mesangium was found in glomerular area.Ubiquitinated proteins,mainly localized in podocytes and tubular epithelial cells,exhibited an apparently higher expression in diabetic mice than control mice (all P ＜ 0.05).Hyperglycemia promoted the ubiquitination in a time-dependent manner.Compared with their normal cells,primary mouse podocyte and primary tubular epithilial cells treated with high glucose for 3 d and 7 d showed increased ubiquitinated protein (all P ＜ 0.05).GRP94 was interspersed in podocytes and proximal tubular epithelial cells.Expression of GRP94 was significantly increased in glomerular area of diabetic mice and podocyte with 3 and 7 day-high glucose as compared with those in their control groups (all P ＜ 0.05).GRP94 expression had no significant change in tubular area and tubular epithilial cells treated with high glucose.Conclusions Hyperglycemia may lead to accumulation of ubiquitinated proteins in intrinsic kidney cells.The imbalance of protein homeostasis in podocyte may contribute to podocyte injury during the onset of diabetic nephropathy.