Drug Resistance ; Glucocorticoids ; therapeutic use ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Membrane Proteins ; genetics ; Mutation ; Nephrotic Syndrome ; drug therapy ; genetics

Adolescent ; Child ; Electroencephalography ; Female ; Fructose ; analogs & derivatives ; therapeutic use ; Humans ; Male ; Migraine Disorders ; diagnostic imaging ; drug therapy ; physiopathology ; Ultrasonography, Doppler, Transcranial

Asians ; China ; Humans ; von Willebrand Diseases/therapy* ; von Willebrand Factor

ADAMTS13 Protein ; Asians ; China ; Humans ; Plasma Exchange ; Purpura, Thrombotic Thrombocytopenic/therapy*

Objective To investigate the effect of clinical risk factors including maternal underlying medical conditions on the development of preeclampsia (PE) in order to improve and strengthen the early assessment of high clinical risk population of PE.Methods Clinical.observational data of patients with PE in Peking University Third Hospital from November 2008 to January 2011 were analyzed.Comparative analysis was made among medical conditions with PE (M-PE) sub-group and isolated PE (I-PE) sub-group and non-PE pregnancy with or without medical conditions (control group).Results Totally 159 cases,43.09％ (159/369) of total cases of PE had high clinical risk factors (multiple pregnancy and medical conditions) and 32.3％ (97/300) of singleton PE accompanied with medical conditions.The incidence of PE in singleton pregnancies with medical conditions was significantly higher than those without medical conditions [ 15.0％ (97/646) versus 4.45％ (210/4719),P ＜ 0.05 ].In M-PE sub-group,the average age [ ( 31.7 ± 4.5 ) versus ( 29.3 ± 5.2) year-old] and body mass index (BMI) in first trimester [ (26.0 ±5.6) versus (23.3 ± 3.7) kg/m2],the proportion with previous preeclampsia [ 11％ (11/97) versus 4.9％ (10/203) ] and pregnancy loss in third trimester [ 11％ ( 11/97 ) versus 3.0％ ( 6/203 ) ],were higher than those of I-PE sub-group ( all P ＜ 0.05 ).The onset of preeclampsia in M-PE sub-group was earlier than I-PE ( 32.9 versus 34.4 gestation weeks,P ＜ 0.05 ).The proportion serious cases of PE occurring before 32 gestational weeks were higher in M-PE than that of I-PE sub-group [ 45％ (44/97)versus 34.0％ (69/203),P ＜0.05].Multivariate regression analysis showed that previous history of late pregnancy loss and irregular prenatal care were clinical risk factors for early-onset PE whether early-onset was defined as ＜ 34 or ＜ 32 gestational weeks respectively (all P ＜ 0.05) ; medical conditions were risk factors for PE if early-onset was defined as ＜ 32 gestational weeks ( OR =1.718,95％ CI:1.005 - 2.937,P =0.048).Conclusions Multiple pregnancies and pregnancies with medical conditions exceed one-third of total subjects of PE.The onset of PE in subjects with maternal underlying medical conditions was earlier which is the subgroup should not be ignored.The difference of early pregnancy BMI may show the maternal heterogeneity in early onset and late onset of preeclampsia.Assessment of clinical risk factors including the underlying medical disorders for preeclampsia in early trimester should be strengthened.

Air Pollutants, Occupational ; Dust ; prevention & control ; Occupational Exposure ; prevention & control ; Workplace

Objective To investigate the relationship between potential maternal risk factors between potential maternal risk factors in different level hospitals as well as different prenatal care patterns and characteristics of preeclampsia. Methods A retrospective study of 300 preeclamptic singleton patients delivered in Peking University Third Hospital was performed.Patients were divided into three groups:regular prenatal care in tertiary hospitals (n =100),regular prenatal care in primary hospitals (n=81) and without prenatal care (n=119). The onset of preeclampsia and incidence of severe preeclampsia of different groups were analyzed. Non-parametric and Chi-square test were adopted for continuous and categorical variables respectively. Results (1) In total cases of preeclampsia subgroup (I-PE subgroup) and with chronic hypertension (CH subgroup),the diagnosis of preeclampsia was later in patient with regular prenatal care in tertiary hospital (patient-TH)[100,64 and 14 cases,37.1 (4.1),37.3 (1.7) and 36.3 (2.5) weeks respectively] than those with regular prenatal care in primary hospital (patient-PH) [81,54 and 9 cases,32.9 (6.7),33.8 (6.1)and 27.9(6.3) weeks respectively] (Z=72.29,51.30 and 14.58 respectively,P＜0.05) or the patient without regular prenatal care (patient-NP) [119,85 and 19 cases,31.6(6.6),31.9(6.7) and 30.3(4.7) weeks respectively] (Z=86.69,58.83 and 11.33 respectively,P＜0.05).The proportion of severe preeclampsia occurred earlier than 32 weeks [13.0％ (13/100) vs 55.5％ (66/119),9.4％(6/64) vs 50.6％(43/85),and 35.7％(5/14) vs 89.5％(17/19); x2=43.95,29.42 and 10.17respectively,P＜0.05] or earlier than 34 weeks [17.0％ (17/100) vs 65.5％ (78/119),14.1％(9/64) vs 61.2％(52/85) and 42.9％(6/14) vs 94.7％(18/19); x2 =47.71,31.18 and 10.61 respectively,P＜0.05] were lower in patient-TH than in patient-NP.(2) In patient-NP and patientPH,onset of preeclampsia was earlier in CH subgroup compared with I-PE subgroup (Z=26.61 and 22.82,P＜ 0.05). In patient-NP,the proportion of severe preeclampsia occurred earlier than 32 weeks (x2 =9.11,P＜0.05) or earlier than 34 weeks (x2 =7.95,P＜0.05) was higher in CH subgroup than in I-PE subgroup. Conclusions Regular prenatal care in tertiary hospital might effectively delay the onset of preeclampsia or severe preeclampsia,especially in patients with risk factors for preeclampsia. Assessment of risk factors for preeclampsia in early trimester should be strengthened and individualized prenatal care plan should be established.

Objective Observes the sparse blood to pass treatmentacute myocardial infarction the curative effect.Meth- ods Will diagnosefor the acute myocardial infarction 62 examples patient stochasticallydivides into the treatment group and the comparison group,thetreatment group gives the sparse blood to pass with the foundationtreatment (including low molecular heparin,aspirin,Betaloc,a ACEI kind of medicine,simvastatin,tallies dissolveshitch to dissolve hitch),the comparison group will give thefoundation treatment,15 days will he a treatment course,through tothe curative effect check analysis,to will count the material tocarry on statistics processing.Results Treatment group totaleffectiveness is 93.5%,obvious is good to the foundation group(60.93%).Conclusion Adds in the traditional convention foundation- treatment with the sparse blood passes treatment acute myocardialinfarction to obtain a better curative effect.

OBJECTIVE To realize the situation of the infection of Ureaplasma urealyticum(Uu) and Mycoplasma hominis(Mh) and the drug resistance among the female patients with urogenital tract infection.METHODS Totally 813 specimens in the female patients with urogenital tract infection were collected,cultured and tested for drug sensitivity with mycoplasma test drug sensitivity kit.RESULTS From the specimens of 813 cases the infection of Uu was in 296 cases(36.4%),the infection of Mh in 13 cases(1.6%),and the mixed was in 71(8.7%) cases,totally 380 cases(46.7%) were infected.The results of drug sensitivity showed that the sensitivities of Uu and Mh to josamycin,doxycycline and minocyclin were remarkable and the drug resistance of Uu and Mh to ofloxacin was the most prominent.CONCLUSIONS The infection of Uu and Mh is high among the femalepatients with urogenital tract infection.Especially the infection of Uu is usual.Uu and Mh have high drug resistance to many antibiotics,especially to ofloxacin.There is some difference between the drug resistances of Uu,Mh and Uu+Mh.To treat the infection of Mycoplasma some antibiotics are good choices,such as josamycin,doxycycline and minocyclin.

10pg/ml and IL-8≥70 pg/ml as the critical value,PCT and IL-6 levels had diagnostic sensitivities of 90.6% and 75.0%,and specificities of 83.3% and 77.7%,respectively.The combination of PCT and IL-6 had a sensitivity of 81.2%,and specificity of 94.2%.The positive predictive value was of 96.2% and the negative predictive value of 73.0%.CONCLUSIONS Serum PCT appears to be a promising indicator in differentiating viral infection from bacterial gastroenteritis,but the combination of PCT and IL-6 has a more clinical value.