Objective To analyze the clinical presentation and maternal neonatal outcome of 30 cases with HELLP syndrome and to discuss the diagnosis, treatment and prognosis of the disease. Methods 30 cases of HELLP syndrome were collected retrospectively including 19 cases of complete HELLP syndrome and 11 partial HELLP syndrome. The blood test, clinical presentations, complications and pregnant outcomes were analyzed. Results LDH value in complete HELLP group(CHG) [(622?481)U/L] was significantly higher than that in partial HELLP group(PHG) [( 369?101) U/L, P

Objective To investigate the relationship between placental endoglin expression and the pathogenesis of severe preeclampsia (SPE). Methods Forty nine pregnant women with SPE and 40 normal pregnant controls were collected in Peking University First Hospital from January 2006 to January 2008,among which,nine SPE patients complicated with fetal growth restriction (FGR),six with hemolysis,elevated liver enzymes and low platelets syndrome (HELLP syndrome) and 12 with heavy proteinuria. The expression of placental endoglin was detected and semi-quantified by immunohistochemistry.Data were analyzed by independent sample t test. Results Endoglin was presented on cell membranes of placental syncytiotrophoblasts and vascular endothelial cells. The endoglin density of SPE group was higher than that of control group (0.1621± 0.0029 vs 0.1576 ± 0.0038,t=- 6.367,P＜0.05).No significant difference in endoglin density was found between FGR group and non-FGR group (0.1611±0.0026 vs 0.1623±0.0029,t=1.107,P＞0.05) ; neither did the heavy proteinuria group and non-heavy proteinuria group (0.1611±0.0032 vs 0.1624±0.0027,t=1.350,P＞0.05).The endoglin density of HELLP group was lower than that of non-HELLP group (0.1595±0.0032 vs 0.1625±0.0027,t=2.495,P=0.016). Conclusions The elevated placental endoglin expression might contribute to the pathogenesis of SPE.

ObjectiveTo understand the implementation effect and its influencing factors of clinical medical undergraduates' talents cultivation scheme in Xinjiang Medical University. Methods 421 clinical medical students completed questionnaire. The main contents of the survey are general situation, the factors and the implementation effect of the cultivation scheme, and so on. Results①The talents cultivation scheme is reasonable and feasible. ②The main factors which affect talents cultivation scheme of our school are the teaching plan arrangement and practical course arrangement. ③Talents cultivation scheme in the implementation process achieved some success, but the cultivation of humanistic quality should be enhanced, etc. ConclusionRenewed the education conception, optimize the clinical teaching structure, integrated teaching contents, updated teaching methods and means, and strengthened students' humanistic quality are the key factors of the higher medical institutions to cultivate high quality and comprehensive talents.

Objective To investigate the incidence changes, clinical characteristics and pregnant outcomes of pernicious placenta previa. Methods A retrospective cohort analysis on 316 cases with placenta previa in the Peking University First Hospital from January 2008 to December 2014. The research group were 60 cases with the patients of placenta previa with the history of cesarean section, and the control group were placenta previa without the history of cesarean section. Compared with the incidence, intraoperative blood loss, the pregnancy outcomes and so on. Results (1) The average incidence rate of placenta previa during the past 7 years was 10.96‰ (316/28 837). And the cases of pernicious placenta previa was 60 (2.08‰, 60/28 837), the incidence of pernicious placenta previa was rising from 2008 to 2014 (0.91‰-3.08‰). (2) There were 145 cases of placenta privia had been translation from other hospitals in the past 7 years. The referral rate of pregnant women with placenta previa was 45.9%(145/316), and the referral rate of pernicious placenta previa (63.3%, 38/60) was significantly higher than that of non-pernicious placenta previa group (41.8%, 107/256; χ2=9.080, P=0.003). Referral the outcomes of these patients were good, and no maternal death occurred. (3) The placenta in the research group were mainly adhered in the front wall of the uterine, and the incidence was 38.5%(15/39), higher than that in the group of non-pernicious placenta previa (12.1%, 21/174; χ2=57.636, P<0.01). The incidence rate of complicated placenta increased in research group was 53.3% (32/60), higher than that in the group of non-pernicious placenta previa, compared with the control group, there was significant difference (15.6%, 40/256; χ2=39.041, P<0.01). (4) The incidence of blood loss was more than 1 000 ml, blood transfusion rate, the rate of hysterectomy and the rate of asphyxia of newborn in the research group were respectively 41.7% (25/60), 38.3%(23/60), 8.3%(5/60), 15.0%(9/60), and the incidence of the group of non-pernicious placenta previa were respectively 4.7%(12/256), 12.9%(33/256), 1.2%(3/256), 8.6%(22/256), compared those in other two groups, there were not significant difference (P<0.05). Conclusions The incidence rate of placenta previa increased year by year, patients with placenta previa has a history of cesarean section often combined with placenta in anterior wall of the uterus, and often with poor pregnancy outcomes. Hierarchical referral system is an effective means to reduce the mortality of the pernicious placenta previa.

OBJECTIVE:To explore the basic principles,advantages and application prospects of Bayesian mixed treatment comparison (MTC),and provide theoretic support for making reasonable decisions of pharmacoeconomics. METHODS:The prob-lems existing in model and method that had been used in the study of pharmacoeconomics as starting point,literature research was used to sort out the domestic development and applications of MTC and study its application and development prospect. RESULTS &CONCLUSIONS:The evaluation methods of pharmacoeconomics play an important role in selection of essential medicines,medi-care insurance directory medicines,basic health and basic public health programs,the results directly affect the total effective rate of medical resources’configuration. The current research models cannot effectively solve the problem,for example,decision tree model is difficult to make evaluation of long-term treatment;Markov model and the use of multiple attribute utility theory are restricted by the model parameters;discrete event simulation is limited because it depends on the epidemiological study and clinical trial. MTC, an extension approach of the traditional Meta-analysis,is an effective new method developed recently to analyze and compare the di-rect or indirect evidence of several different clinical treatment factors in order to make a comprehensive evaluation of the various inter-ventions in the absence of evidence support. So the MTC can make up for the limitation of current evaluation methods.

0. 05). No significant difference was found in maternal and neonatal complications between the ANCA( + ) and ANCA(－) subgroups in S-PE subjects. But those 4 cases who developed renal function insufficiency patients were ANCA( + ). Conclusions ANCA might be associated with renal diseases in preeclampsia women, and further studies is required to determine whether ANCA is involved with the pathogenesis of preeclampsia.

Objective To investigate the effect and mechanism of low-dose remifentanil(RF)on systemic artery tension of baby rabbit with septic shock.Methods Thirty-six systemic artery strips were prepared from 12 baby rabbits and randomly divided into 6 groups:control group,lipopoly-saccharide(LPS)group,RF group,LPS + RF group,NG-nitro-L-arginine(L-NNA)pretreated group,LPS + L-NNA pretreated group.Each group had six rings(n =6).The effect of low-dose RF on the systemic artery tension of baby rabbit with septic shock was observed with isolated vascular ring technique.The change was also obversed after L-NNA pretreatment.Results In control group:the relaxant rates after low-dose RF at the time point of 5 min,10 min,20 min were(18.48±3.96)％,(23.63±4.42)％,(28.33±3.73)％(P＜0.05),compared with NS group.After pretreatment with L-NNA,RF-related relaxant rates of systemic arteries decreased significantly to(8.15 ± 1.01)％,(13.08 ± 1.46)％,(18.54 ±2.94)％(P ＜ 0.05).In LPS group,low dose RF(4 μg/L)did not bring out any response to systemic arteries(P ＞0.05).The tension was not affected with pretreatment of L-NNA(P ＞ 0.05).Conclusion These results suggest that low dose RF has relaxant effect on systemic arteries of baby rabbits,and NO may be involved.Low dose RF has no relaxant effect on LPS-pretreated systemic arteries of baby rabbits,and it has no association with NO.

Objective To investigate the prenatal diagnosis and prognosis of fetuses with mild ventriculomegaly in order to provide evidence for clinical consultation and treatment.Methods The data of 116 mothers with fetal ventriculomegaly who received prenatal care in Peking University First Hospital between January 1,2013 and May 31,2015 were retrospectively analyzed.All cases of fetal ventriculomegaly were found by ultrasound screening,and were subsequently diagnosed by ultrasound consultation as mild ventriculomegaly.The results of fetal cerebral MRI and invasive prenatal diagnosis were analyzed and the growth and development of babies were followed up by telephone using the Gesell developmental scale.All data was analyzed by descriptive statistics.Results Of the 88 cases of solitary ventriculomegaly,48 (54.5％) received karyotype analysis or screening,and only one case was found to be abnormal,which was an unbalanced translocation.Of the 83 mothers with normal delivery,only one infant (1.2％) showed retardation of intelligence and motor development.Of the 28 cases of non-solitary ventriculomegaly,17 (60.7％) received karyotype analysis or screening,and no abnormalities were found.Of the 18 mothers with normal delivery,only one infant showed retardation of growth and development,and was found to have brain hypoplasia before delivery by MRI with normal karyotype.Conclusions The rate of abnormal karyotype in mild vetriculomegaly is very low in this study.The width of the lateral ventricles is stable during pregnancy and the prognosis of infants is good.Thus,whether invasive prenatal diagnosis is necessary for all the fetuses with isolated mild ventriculomegaly remains to be confirmed.

Objective To discuss the serum endoglin expression in severe pre-eclampsia and eclampsia women and their relationships. Methods Forty-two severe pre-eclamptic patients and 4 eclamptic patients in Peking University First Hospital from Dec. 2005 to Dec. 2007 were enrolled in the study group, with the mean gestational week of 35 ± 4, the mean age of 29.3 ± 5.7 and the mean BMI (30.1 ± 4.1 ) kg/ m2. This group included 25 cases of early onset pre-eclampsia, 21 cases of late onset pre-eclampsia, 8 cases of fetal growth restriction and 5 cases of HELLP syndrome. The control group included 29 cases of normal pregnant women during the same period, with the mean gestational week of 33±4, the mean age of 30.7± 3.4 and the mean BMI(27.2±2. 2) kg/m2. Peripheral serum endoglin was determined by ELISA in these two groups. Results (1)There is positive correlation between serum soluble endoglin level and the gestational weeks during 27 to 37 gestational weeks in the control group (r=0.79, P<0.05), but there is no distinct relationship in the study group (r=0.31, P>0.05). (2) Serum endoglin level of severe pre-eclampsia group was higher than the normal group [(14.2±5.6)μg/L vs. ( 10.9 ± 4.2 ) μg/L, P<0.05]. (3) Serum endoglin level of early onset group did not differ from late onset group [(14.3±5.7)μg/L vs. (13.6±5.0)μg/L, P >0.05]. (4) No difference of serum endoglin between HELLP group and non-HELLP group was found [(10.1±2.9) μg/L vs. ( 14.4±5.4) μg/L, P>0.05 ]. (5) Serum endoglin level of FGR sub group was higher than non-FGR sub group [(17.3±6.1) μg/L vs. (13.0±4.8) μg/L, P < 0.05] in the stady group. Conclusion The elevated peripheral serum endoglin level may contributes to the pathogenesis of severe pre-eclampsia and FGR, but not the week of the onset of the disease.

Objective To investigate the efficiency of ring butterfly sewing in lower uterine segment aided with tourniquet in treating pernicious placenta previa combined with placenta percreta. Methods Twelve pregnant women diagnosed with pernicious placenta previa combined with placenta percreta by prenatal ultrasound in Peking University First Hospital from April 1, 2012 to November 30, 2014, were enrolled. All of them received elective cesarean delivery using ring butterfly sewing in lower uterine segment aided with tourniquet. The efficiency of this novel technique, in term of blood loss and vital signs during operation, blood transfusion, and postoperative recovery, was analyzed. Results Twelve cases were diagnosed with placenta percreta during operation, with placenta invading the perimetrium in seven cases and urinary bladder being involved in one case. Ring butterfly sewing in lower uterine segment aided with tourniquet during elective cesarean delivery was all successful in the 12 cases. The median amount of blood loss was 1 000(400-2 000) ml during operation and the amount of blood loss was lower than 1 000 ml in three cases. Two cases received no blood transfusion, and the median blood transfusion in the other 10 cases were 400(400-1 200) ml. The mean operation time was (75±22) min (43-131) min. Eleven cases had normal lochia and temperature after operation and the other one had placenta invading urinary bladder and partial placenta in situ, and developed fever at day 3 after operation, but recovered after antibiotic treatment, and no placenta tissue was seen by ultrasound at day 59 after operation. Conclusions The ring butterfly sewing in lower uterine segment aided with tourniquet is highly effective for the pernicious placenta previa combined with placenta percreta, and it is a simple, fast and fertility sparing technique with low blood loss and without usage of special equipment.