AIM: To investigate the protective effects and mechanisms of methylflavonolamine (MFA) on myocardial injury induced by adriamycin in mice. METHODS: The myocardial injury was induced by adriamycin (ADR) 1.5 mg?kg -1 ip once every two days for ten days in mice. All mice were taken the electrocardiogram examination before given drugs. The mice with abnormal electrocardiogram were excluded prior to the experiment. The degree of J point elevation, the prolonged degree of the QRS complex duration and the Q T interval, the change of contents of serum creatine phosphokinase (CK), serum lactate dehydrogenase (LDH), myocardial malondialdehyde (MDA), and the activity of myocardial superoxide dismutase (SOD) were observed in control and treated groups. The contents of serum CK and LDH were measured by spectrophotometry, and the content of myocardial MDA was measured by TBA method and the activity of myocardial SOD by hydroxylamine method. RESULTS: The J point was elevated, the Q T interval and the duration of QRS complex were prolonged and the contents of serum CK and LDH were increased in mice with acute myocardial injury induced by ADR, suggesting that a widespread and severe myocardial cell injury occurred in the prepared models. While all these injury indices were reversed by MFA treatment. The content of myocardial MDA was increased and the activity of myocardial SOD was decreased in mice with myocardial injury, and MFA decreased the MDA content and increased the SOD activity, indicating that it possesses the actions of scavenging free oxygen radicals and anti lipoperoxidation. CONCLUSIONS: MFA significantly alleviates the degree of the acute myocardial injury in mice induced by ADR. Its mechanism may be associated with reducing oxygen free radical production and anti lipoperoxidation.

OBJECTIVE To analyze the of non-gonococcal urethritis(NGU) secretion in patients with urogenital mycoplasma infection and drug sensitivity status to provide the basis for clinical rational drug use.METHODS The mycoplasma culturing,identification,counting and drug sensitivity test to 12 kinds of antimicrobial drugs were conducted among 279 cases of NGU patients and the sensitivity of mycoplasma was monitored by retrospectively statistical analysis.RESULTS A total of 162 strains were isolated from 279 cases with NGU(58.1%).Ureaplasma urealyticum(Uu) was found in 115 cases(70.9%),Mycoplasma hominis(Mh) positive in 9 cases(5.6%) and 38 cases were with mixed infection(23.5%).The sexually active population of 21-35-year-old was with the highest incidence,accounted for 53.7% from all of NGU cases.The sensitivity to minocycline,Tetracycline,of were higher but resistant to Erythromycin,sparfloxacin Mycoplasma.CONCLUSIONS Uu is the major pathogens in NGU patients,minocycline and tetracycline treatment for mycoplasma infection is better choice.The NGU pathogen detection and drug sensitivity test are important for guiding clinical treatment in order to maximize control of the emergence of resistant strains particularly important.

Biodegradable polymers as drug delivery systems have attracted investigators. They degrade in biological fluids to produce biocompatible and nontoxic products, which could be removed from the body by normal physiological pathways without extra surgical removal. In this article, literatures on biodegradable polymers mainly served as matrix in controlled release systems are analyzed and reviewed.

Objective To investigate the etiology and perinatal outcome of pregnancies complicated with extremely severe thrombocytopenia [ at least two times of platelets count (PLT) < 10 × 109/L during pregnancy]. Methods Clinical data, including basic information, etiology, management and outcomes of pregnant women with extremely severe thrombocytopenia, admitted to Peking University People's Hospital from January 2004 to March 2009, were retrospectively collected. The management of these cases varied according to different etiology and the symptoms: (1) PLT were maitained > 20 × 109/L and hemoglobulin> 70 g/L in those women without spontaneous bleeding; (2) PLT transfusion would be required when PLT< 10 × 109/L or bleeding occur and RBC would be supplied when hematocrit <25% and hemoglobulin <70g/L; (3) Hemoglobulin should be > 70 g/L and PLT >30 × 109/L before cesarean section or delivery;(4) Predinisone and/or intravenous immunoglobulin G (IVIG) would be given in women complicated with idiopathic thrombocytopenic purpura (ITP) when PLT < (20-30) × 109/L or bleeding. PLT would be given if all the above management were failed, or PLT < 10 × 109/L, or bleeding. Women without bleeding would be closely monitored and delivery would be planned. Results (1) Twenty-six cases were identified among 9302 deliveries during the study period (0.28%), with an average of maternal age of 29. Seventeen were diagnosed before conception and 9 during pregnancy. Among the 26 women, half received regular prenatal check in our hospital and the average gestations at diagnosis was 24 weeks and the other half without regular prenatal visits and the average gestations at diagnosis was 32 weeks. Etiology was identified in 24 out of the 26 women, including 14(54%) ITP, 5 myelodysplastic syndrome (MDS), 4 chronic aplastic anaemia(CAA) and 1 systemic lupus erythematosus (SLE). (2) Management: All of the 26 women received blood products. Among the 14 ITP cases, 6 received predinisone and IVIG and 8 only took predinisone. Nine of the 26 patients (35%) had pregnant complications, among which 6 (6/9) were preeclampsia. The overall average gestation at delivery was 36 weeks. Only 2 delivered vaginally with the average blood loss of 83 ml and 23 cesarean sections were performed with the average blood loss of 410 ml. (3) Perinatal outcomes:There were 26 perinatal babies, among which 1 died intrauterine and 25 were born alive (12 preterm infants). The average birth weight was 2877 g. Neonatal severe thrombocytopenia presented in 2 newborns whose mother complicated with ITP. Conclusions The main cause of extremely severe thrombocytopenia during pregnancy is ITP, managed mainly by predinisone and IVIG, followed by CAA and MDS, which may require supportive treatment. Pregnancy complicated with extremely severe thrombocytopenia is not an indication of termination. Better maternal and fetal outcomes can be achieved through proper treatment based on the etiology, intensive care in prevention and management of complications and cesarean section.

Objective To evaluate the diagnosis and the optimal management of idiopathic thrombocytopenic purpura(ITP) with pregnancy and the related high risk factors with neonatal passive immune thrombocytopenia(PIT) occurring in infants born to mothers with ITP. Methods Medical records of 40 pregnant women with ITP and their neonatal outcomes were reviewed retrospectively from 1992.2 to 2001.8 in our hospital. Results The incidence of pregnancy with ITP was 3.4‰. The maternal complications included pregnancy-induced hypertension syndrome (17.5%), postpartum hemorrhage (15%), preterm labor (12.5%), gestational diabetes(7.5%) and FGR (7.5% ). One mother died at 36 weeks of gestational age. There were 13 cases delivered by vagina and 27 cases delivered by cesarean section. Nine neonates(28.1%)had neonatal PIT, Among them three neonates (9.3%) had severe PIT, One neonate(2.5%) had an intracranial hemorrhage(ICH) and two perinatal death (5%)occured in 40 neonates. No significant correlation was found between neonatal platelet counts and maternal platelet counts, maternal PAIgG values and maternal treatments respectively. Conclusion The prognosis of mothers and neonates in pregnancy with ITP are better. The incidence of severe fetal or neonatal PIT is low and not related to maternal platelet counts, maternal treatments and PAIgG values.

Objective To investigate the diagnosis, management, pregnancy outcome and prognosis of bieytopenia or pancytopenia during pregnancy. Methods Retrospective chart review was conducted on 24 pregnancies who were found bicytopenia or pancytopenia during pregnancy for the first time. The diagnoses were reconfirmed. The management and pregnancy outcome were collected. And the prognoses were followed. Results According to the clinical data and laboratory findings, the latter including complete blood cell count, reticulocyte count, peripheral smear, serum folate and vitamin B12 level, autoimmune antibody screening, bone marrow smear and biopsy, thirteen patients were diagnosed as having chronic aplastic anemia (CAA), six as having myelodysplastic syndromes (MDS), two as having megaloblastic anemia(MA), one as having paroxysmal nocturnal hemoglobinuria(PNH), one as having Evan's syndrome and one as having acute leukemia. The management basically consisted of supportive transfusions. Six patients suffered pregnancy complications including four with severe preeclampsia (one with intraeranial hemorrhage and one with intrauterine death concomitantly) and two with gestational diabetes. The delivery ages of the 21 patients were term or nearly term with all good neonatal outcomes. Postpartum follow-up showed the two patients with MA achieved complete remission, the one with PNH had mild anemia and that with Evan's syndrome had mild thrombocytopenia. The patient with acute leukemia died of recurrence six months postpartum. Of the thirteen patients with CAA, two achieved complete remission, six partial remission, four no remission and one was lost follow-up. Of the 6 patients with MDS, one achieved partial remission, four no remission, and one transformed into acute monocytic leukemia, then refused chemotherapy and was lost follow-up. Conclusions CAA may be one of the most common causes of bicytopenia or pancytopenia during pregnancy, MDS may be the second. Diagnosis should be made as soon as possible through appropriate and reasonable laboratory examinations. Most patients could achieve good pregnancy outcomes through supportive management. The maternal prognosis may vary widely depending on the causes.

Objective To explore the different effects on the bleeding after the surgery of minimally invasive intracranial haematoma with drainage method.Methods The cases with minimally haematoma invasive operation were divided into A and B group.Group A simply used the liquefaction agent for blood clots( urokinase mixed with hyaluronidase),without washing step,and Group B used saline water to wash repeatedly and then use liquefaction agent to divert.Results The hematoma clearance rate of A group equal to that of B Group,while the rate of re-bleeding was ( 3.8 ％ ) obviously lower than than of B Group ( 22.7％ ) ( x2 =4.594,P ＜ 0.05 ).Condusion For many cases who have experienced the minimally invasive intracranial operation,the simple use of liquefaction agent can divert haematoma,and the risky rate of re-bleeding was obviously lowered.

Objective To investigate the perinatal outcomes of pregnancies complicated with varying degrees of thrombocytopenia.Methods Clinical data of 305 pregnant women with thrombocytopenia,who admitted to Peking University People's Hospital from January 1,2000 to January 31,2010 were retrospectively analyzed.The etiological diagnosis of them were gestational thrombocytopenia (GT),idiopathic thrombocytopenic purpura (ITP) or undetermined.The patients were divided into 4 groups according to the minimal level of platelets in pregnancy ( platelets count was lower than 100 ×109/L at least twice) : groupⅠ,(50-100) ×109/L (n=101) ; group Ⅱ,(30-50) × 109/L (n = 85); group Ⅲ,(10-30) × 109/L (n = 87); group Ⅳ,< 10 × 109/L (n = 32).Demographic data such as pregnancy complications,treatment,neonates and follow-up results of the patients in each group were compared with ANOVA,Spearman rank correlation analysis,Chirsquare test and Chi-square trend test in SPSS 17.0.Results Medical complications in pregnancy of these patients included hypertensive disorder complicating (n = 35,11.48%) and abnormal glucose metabolism (n=23,7.54%),no difference was found in the incidence of these diseases among the four groups.There were 68 patients complicated with anemia (22.30%),40 preterm delivery (13.11%),60 postpartum hemorrhage (19.67%); there were significant differences in the incidence among the four groups (P＜0.05),the incidence increased with the aggravation of thrombocytopenia (P＜0.05).There were 2 cases of puerperal infection (0.66%),no maternal deaths.Fifty-one patients (16.72%) accepted treatment of corticosteroids or Gamma globulin during pregnancy.There were 116 cases (38.03%) of vaginal delivery and 189 cases (61.97%) of cesarean section.The postpartum bleeding amount within 24 hours increased with the aggravation of thrombocytopenia.Two hundred and eleven (69.18%) patients were followed up and platelet count regained normal,among which 152 cases recovered within six months after delivery.The recovery rates were 90.59% (77/85),82.36% (42/51),46.16% (24/52) and 39.13% (9/23) from group Ⅰ to group Ⅳ,as declined with the aggravation of thrombocytopenia in pregnancy ( x2trend = 42.616,Ptrend =0.000).Among the 306 perinatal fetuses,neonatal outcomes included 301 live births,5 fetal deaths,4 early neonatal deaths,4 low birth-weight infants after term birth,1 intracranial hemorrhage and 18 (5.98%) neonatal thrombocytopenia cases.Incidence of neonatal thrombocytopenia increased with the aggravation of maternal thrombocytopenia.Sixteen cases of neonatal thrombocytopenia recovered at 3-8 weeks after birth,but two cases did not recover within three years during followed up.Conclusions The perinatal outcomes are different in pregnancies complicated with varying degrees of thrombocytopenia.As thrombocytopenia in pregnancy become worse,the risk of anemia,premature delivery,postpartum hemorrhage and neonatal thrombocytopenia increases.While,perinatal outcomes may be better under close perinatal care.

Physician-patient communication skill is the core clinical capability,and its im-portance is more and more recognized by educationists.Introducing the communication skill education into the standardized resident training can improve the residents'clinical and communicative ability and train them to be the comprehensive quality talents.

Objective The normothermic isolated contracting rat heart model was used to investigate the mechanism of protective effect of propofol on left ventricular function and myocardial metabolism against ischemia-reperfusion injury by determination of the catecholamme concentration in the coronary outflow. Methods forty healthy male SD rats weighing 310-450 g were randomly divided into 4 groups of each 10 animals: control group, propofol 10?mol/L (P10), 50?mol/L (P50) and 100?mol/L (P100). The animal were sacrificed by knock-out and the heart was immediately removed. The aorta was connected to a Larigendorff apparatus and retrogradely perfused with oxygenated (95% O, and 5% CO2) Krebs-Henseleit buffer (KHB) for 5 min. Then the left ventricle was perfused through a cannula inserted in pulmonary vein at a constant pressure of 12.5 cm H2O (preload). The pressure at aorta outflow was 90 cm H2O (afterload). Different concentrations of propofol in KHB were prepared. Global ischemia of the heart was induced by suspension of perfusion for 25 min followed by 30 min reperfusion. Coronary flow (CF), aortic flow (AF), cardiac output (CO = AF + CF), HR, left ventricular peak systolic pressure (LVPSP), left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (LVDP = LVPSP-LVEDP) and the product of LVDP and HR were measured and recorded 5 min and immediately before ischemia and 5, 10, 15, 20, 25 and 30 min following reperfusion. Coronary outflow was collected for determination of creatine kinase (CK) and catecholamine ( epinephrine, norepinephrine and dopamine) concentrations.Results Before ischemia CF was significantly higher and CO, HR, LVPSP and LVDP ? HR were significantly lower in the 3 propofol groups in comparison with the controls. During reperfusion CF, CO, HR, LVPSP and LVEDP recovered much better in the propofol groups than those in control group. In group P50 LVDP ? HR reached 88.7% of the pre-ischemic value while in control group only 56.3% . The CK and catecholamine concentrations were not significantly different among the 4 groups before ischemia. During reperfusion CK, epinephrine and noeepinepherine concentrations were significantly lower in propofol groups than in control group (P