Objective To investigate the expression and significance of Rho-associated protein kinaseⅡ(Rock Ⅱ)in preeclamptic placenta and umbilical artery.Methods Semiquanfitative RT-PCR and Western blot were used to investigate the expression of RockⅡmRNA and RockⅡprotein in placenta and umbilical artery from 35 women with moderate preeclampsia(MPE group)、38 women with severepreeclampsia(SPE group)and 45 normal third trimester pregnant women(control group),the S/D value of umbilical artery was examined by ultrasound.Results (1)The expression of Rock Ⅱ mRNA of Dlacenta in MPE group(0.82±0.14)and SPE group(0.93±0.13)were signifieantly higher than that in control group (0.70 ±0.12,P＜0.01).The expression of Rock Ⅱ protein of placenta in MPE group(0.79±0.15)and SPE group(0.92±0.12)were significantly higher compared with control group(0.68±0.11,P<0.01).The expression of Rock Ⅱ mRNA and protein of placenta in SPE group were higher compared with MPE group(P＜0.01).(2)The expression of Rock Ⅱ mRNA of umbilical artery in MPE group(0.69±0.13)and SPE group(0.55±0.12)were significantly lower than that in control gmup(0.76±0.10,P＜0.01).The expression of RockⅡ protein of umbilical artery in MPE group(0.68±0.10)and SPE group(0.51±0.12)were lower compared with control group(0.75±0.13,P＜0.01).The expression of RockⅡ mRNA and protein of umbilical artery in SPE group were significantly lower compared with MPE group(P＜0.01).(3)There were no correlations between the expression of RockⅡ mRNA and protein in placenta and umbilical artery and the S/D value and birth weight(P＞0.05).Conclusion The upregulated expression of Hock Ⅱ in placentas and downregulated expression in umbilical artery may be a compensation in preeclampsia.

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Objective To study the diagnostic value of hepatobiliary imaging at 6 h post-injection of 99 Tcm-diethyl iminodiacetic acid ( EHIDA) ( HI-6) combined with serum gamma-glutamyltransferase (γ-GT)/total bile acid ( TBA) ratio ( combined diagnosis) in children with congenital extrahepatic biliary atre-sia (CEBA). Methods Clinical data of 194 pediatric patients (118 males, 76 females, mean 70.9 d) with jaundice from May 2013 to March 2017 were retrospectively analyzed. All patients underwent surgery. According to the operation and pathologic diagnosis, patients were divided into CEBA group ( 113 cases) , infant hepatitis syndrome ( IHS) group ( 81 cases) . Serumγ-GT, TBA and the ratio ofγ-GT/TBA of the 2 groups were compared. Receiver operating characteristic ( ROC) curves were drawn to determine threshold values of the 3 parameters for diagnosis of CEBA. Patients also underwent 99 Tcm-EHIDA hepatobiliary dy-namic imaging. The diagnostic efficacies of HI-6, γ-GT, γ-GT/TBA ratio, and combined diagnosis were compared. Two-sample t test and χ2 test were used to analyze the data. Results There were significant differences in γ-GT/TBA ratio,γ-GT and TBA content between the 2 groups (t values:8.217, 9.298 and 2.426, all P<0.05). The serumγ-GT andγ-GT/TBA ratio had high diagnostic accuracies (area under ROC curve ( AUC):0.884 and 0.863) . The sensitivity, specificity, accuracy and positive predictive value of HI-6 in the diagnosis of CEBA were 91.15％(103/113), 39.51％(32/81), 69.59％(135/194) and 67.76％(103/152);the parameters of γ-GT were 69.91％(79/113), 93.83％(76/81), 79.90％(155/194) and 94.05％(79/84);and those ofγ-GT/TBA ratio were 71.68％(81/113), 92.59％(75/81), 80.41％(156/194) and 93.10％(81/87). The sensitivity of HI-6 was significantly higher than that of γ-GT and GGT/TBA ratio (χ2 values:16.256 and 14.154, both P<0.05) , but the specificity, accuracy and positive predic-tive value were significantly lower than those ofγ-GT/TBA ratio (χ2 values:50.899, 6.062 and 20.054, all P<0.05). The specificity, accuracy and positive predictive value of the combined diagnosis were 95.06％(77/81), 92.78％(180/194) and 96.26％(103/107) respectively, which were significantly higher than those of HI-6 (χ2 values:56.786, 34.168 and 31.335, all P<0.05) . Conclusions HI-6 combined withγ-GT/TBA ratio can significantly improve the diagnostic specificity and accuracy for CEBA. This method is more time-saving, simple and reliable, and has important clinical value.

Due to the physiological peculiarities of pregnant women, general clinical studies exclude pregnant women. Therefore, there is a lack of evidence of precise medication for pregnant women with diseases worldwide, which poses a significant risk for them to use medication during pregnancy. Whether to include pregnant women as subjects in clinical research has always been a focus of ethical discussion. By providing a broad overview of pregnant women’s participation in clinical research from an ethical perspective, this paper explored the risks and challenges faced by pregnant women’s participation in clinical research, and provided theoretical basis and thinking paths for how to fairly and effectively include pregnant women as subjects and promoting clinical research on pregnant women.

By searching the papers about medical ethics education in Chinese database CNKI and foreign database Web of Science Core Collection, and using the bibliometrics software CiteSpace to draw the knowledge map of medical ethics education at home and abroad, this paper conducted a quantitative and qualitative analysis of the evolution of hot spots and the development trend of medical ethics education research, and found that the development level of medical ethics education in the world varies greatly. China has experienced the development and evolution from medical ethics education to medical humanities, and its research hotspots mainly focus on the topics of "medical ethics" "medical education" "practice teaching" "medical humanities" "teaching reform" and so on. While foreign countries focus on "medical education" "clinical ethics" "hospice care" "health care" "global public health" "science and technology ethics" "organ transplantation" "curriculum construction" "health policy" and other topics. Through the comparative analysis of the development trend and the evolution of hot spots of education, this paper put forward theoretical reference direction for improving the medical ethics education system in China and further perfecting the discipline construction of medical ethics in China.