Objective To investigate the role of subtype 1 autoantibody against angiotensin Ⅱ receptor in the pathogenesis of preeclampsia by detecting its expression in the peripheral blood of preeclampsia patients,Methods Thirty patients with preeclampsia were assigned to preeclampsia group. Twenty normal pregnant women at the late stage and twenty non-pregnant healthy women as controls were investigated. The level of type 1 antoantibody against angiotensin Ⅱ in the peripheral blood was detected by indirect SA-ELISA assay with the produced ATR-1 as the antigen. Results The level of subtype 1 antoantibody against angiotensin Ⅱ (65 ±4. 7) % in the peripheral blood of preeclampsia patients is significantly higher than that of normal late pregnant (26 ±2. 8)% and non-pregnant women(7.8 ±2. 2)% groups (t1 =24. 97 ;t2 =38.56;P ＜0. 01 for both) ;The angiotensin Ⅱ receptor subtype 1 autoantibody in the group of normal late pregnancy (26 ± 2. 8 )% was significantly higher than that of healthy non-pregnant women group ( 7. 8 ± 2. 2 ) % ( t = 4. 58, P ＜ 0. 05 ).Conclusion Compared with the normal pregnant women and the healthy non-pregant women, the autoantibody against AT1 receptor in sera of preeclamptic patients is elevated ata high frequency. These results suggest that overproduction of AT1-AA may play an important role during the development of preeclamptic patients. AT1-AA is a novel risk factor in pregnant women. Immune mechanisms may be involved in the process of pregnancy.

Objective:To explore the value of series situational simulation teaching combined with symptoms-centered integrated teaching mode in clinical clerkship of obstetrics and gynecology.Methods:A total of 181 students from Batch 2016 of Clinical Medicine (experimental group) were enrolled to receive the series situational simulation teaching combined with symptoms-centered integrated teaching mode. The teaching results were evaluated by formative evaluation scores and questionnaire, compared with 195 students from Batch 2015 (control group). The statistical analysis was performed with SPSS 21.0.Results:Scores of formative evaluation in experimental group [(88.66±5.92) points] was higher than those in control group [(81.11±7.36) points], with statistically significant differences ( P<0.05). Satisfaction of students for teaching flexibility, teaching innovation, learning interest and clinical thinking in experimental group was greater than that of students in control group ( P<0.05). Meanwhile, compared with the control group, teachers from experimental group were more satisfied with teaching flexibility, teaching integration, students' participation and activity in classroom and cultivation of the clinical thinking ability and post competences ( P<0.05). Conclusion:The series situational simulation teaching combined with symptoms-centered integrated teaching mode can help students to form a systemic knowledge system, cultivate their clinical thinking ability and establish a holistic view of disease.

Background:Pancreatic exocrine insufficiency(PEI)after gastrectomy can lead to weight loss,diarrhea,abdominal distension,fat malabsorption and other symptoms,which seriously affects patients'quality of life.Aims:To investigate the incidence of PEI after gastrectomy and the efficacy of pancreatic enzyme replacement therapy(PERT).Methods:Studies on PEI after gastrectomy and/or efficacy of PERT were retrieved from PubMed,Embase,Web of Science,CNKI,Wanfang Data and VIP databases from the date of database establishment to January 2024.Two researchers independently screened the literature,extracted data,and assessed the risk of bias about included studies.Meta-analysis was conducted by Stata 12.0 software.Results:A total of 16 studies involving 974 patients were included in the meta-analysis,of which 14 studies reported the incidence of PEI after gastrectomy,and 2 studies reported the efficacy of PERT.The incidence of PEI after gastrectomy was 43.8%(95%CI:0.295-0.585).Subgroup analysis showed that the incidence of PEI after gastric cancer surgery was 82.1%(95%CI:0.541-0.991),the incidence of PEI in patients underwent total gastrectomy with Roux-en-Y reconstruction and partial gastrectomy with Billroth Ⅱ reconstruction were 60.4%(95%CI:0.489-0.719)and 63.5%(95%CI:0.511-0.759),respectively,and the incidence of PEI after bariatric surgery with billiopancreatic diversion with duodenal switch(BPD/DS)was 67.3%(95%CI:0.542-0.804).Early intervention of PERT after total gastrectomy could reduce fecal fat content at 24 hours(SMD=-1.24,95%CI:-1.56--0.91,P<0.001)and 72 hours(SMD=-1.41,95%CI:-1.74--1.07,P<0.001),and the number of patients with 24-hour fecal fat content＞7 g(OR=0.21,95%CI:0.09-0.53,P=0.001).Conclusions:PEI is common after gastrectomy,and clinicians should pay more attention on it,especially in gastric cancer patients undergoing gastrectomy,Roux-en-Y reconstruction after total gastrectomy,Billroth Ⅱ reconstruction after partial gastrectomy and bariatric surgery with BPD/DS.Fat malabsorption caused by PEI in patients after total gastrectomy can be improved by PERT.