Objective:The characteristics and changes of the three-dimensional micro structure of human placenta in Early-onset severe preeclampsia (EOSP) were quantified, and the relationship of morphologic features and the poor fetal prognosis was explored. Methods:10 patients were recruited in EOSP group, 10 normal blood pressure premature pregnancy were as control group. Ultrathin sections were observed by elec-tron microscope. The Vv,Sv,Nv of plancenta were measured by stereology method. These parameters were compared between the two groups. Results:①In EOSP group, the miorovillus at the bottom of syncytial was sparse and swollen. The mitochondria and endoplasmic reticulum were swollen and dilated. The deposition of lipid granules were increased.②The Vv, Sv of mitochondrial and endoplasmic reticulum in EOSP group were significant augmented than control groups( P<0.01 ). There was no significant difference of Nv in mitochon-drion and endoplasmic reticulum between two groups ( P >0.05). ③The Vv,Sv, Nv of microvilli in EOSP group were smaller than those in control group ( P < 0.01 ). Conclusions. In EOSP, the microstructure of placenta is impaired, thus the synthesis and transportation function of placenta were affected, so fetus could be injured subsequently.

Objective To investigate the effective administration model for gestational diabetes mellitus (GDM) in the community. Methods In a prospective study, the 75 g oral glucose tolerance test (OGTT) was performed in 4 713 resident pregnant women over 20 years old who received antenatal care in a general hospital or a special hospital from Sep. 2011 to Aug. 2012. Five hundred and thirty-three pregnant women were diagnosed as GDM, 198 patients who labored in a general hospital were enrolled in thegroup A , and the rest who labored in a special hospital were enrolled in the group B. 198 cases with non-GDM were enrolled in the group C. Results The incidence of GDM during this study period was 11.3%. The maternal age , gestationl weeks and OGTT results of patients in the three groups were significantly different (P < 0.05). With the increase of maternal age of pregnant women, the blood glucose increased while the gestationl weeks descreased. No significant differencees were shown in prevalence of polyhydramnios, hypertensive disorder complicating pregnancy, premature labor, macrosomia , fetal growth restriction and neonatal asphyxia among the three groups (P > 0.05). However, significant differences were found in the incidence of postpartum hemorrhage and cesarean section. The incidence of postpartum hemorrhage increased significantly in the patients of group B (χ2= 7.156, v = 2, P = 0.028). The incidence of cesarean section increased significantly in the patients of group A (χ2= 63.592, v = 2, P = 0.000). Conclusion Establishing an effective administration model for gestational diabetes mellitus in the community could control the incidence of GDM associated complications.

Objective To explore the correlation of the reversely increased results of 75g oral glucose tolerance test (OGTT) during pregnancy to the pregnancy outcome, so as to provide a reliable theoretical basis of the early intervention for the pregnant women with high plasma glucose.Methods The clinical data of 461 cases were retrospectively analyzed. Patients were chosen from the pregnant women undergoing routine antenatal examination in our hospital during 2014. According to the results of 75g OGTT, 226 patients were analyzed as the observation group, in whom the level of postprandial 2-hour plasma glucose was higher than that of postprandial 1-hour plasma glucose. Meanwhile 235 pregnant women with or without gestational diabetes mellitus (GDM) were randomly selected as the control group.Results The levels of fasting plasma glucose and 1-hour postprandial plasma glucose were lower, but those of 2-hour postprandial plasma glucose was higher in observation group than in control group (P<0.01). No statistical difference existed between the two groups (P>0.05) in the incidences of polyhydramnios, oligohydramnios, fetal growth restriction (FGR), premature labor (PTL), pregnancy induced hypertension (PIH), complicated with premature rupture of membrane (PROM), intrauterine fetal death (IUFD) and non scar uterus cesarean section rate (CSR). Compared with the observation group, the rates of neonatal dysplasia and neonatal asphyxia and the newborn transfer rate were lower in the control group, of which the newborn transfer rate was statistically different (P<0.01).Conclusions There might be a delayed plasma glucose metabolism in the patients with reversely increased result of 75g OGTT during pregnancy, which may affect the long-term prognosis of the newborn. Therefore, more attention should be paid to such patients with reversely increased result of 75g OGTT.

ObjectiveTo evaluate the effects of diagnosis of cervical insufficiency and different management on pregnancy outcomes.MethodsFrom June 2004 to May 2010, a retrospective analysis was carried out on 554 patients with cervical insufficiency in nine hospitals in Guangdong Province, China. The patients were divided into two groups, the cervical cerclage surgical treatment group (surgical group,n=357) and the expectant treatment group (n=197). These patients were then re-diagnosed according to the unified diagnostic criteria by the American College of Obstetricians and Gynecologists (2014), and divided into the definite diagnosis group (n=425) and the indefinite diagnosis group (n=129). The two independent samplest-test andChi-square test were used to compare pregnancy outcomes between the definite and indefinite diagnosis groups, and the different treatment groups.ResultsThe full-term delivery rate in the surgical group was significantly higher than that in the expectant treatment group [40.3% (144/357) vs 23.4% (46/197),χ2=16.254, P=0.000], and the late abortion rate was lower in the surgical group than in the expectant treatment group [22.4%(80/357) vs 40.1% (79/197),χ2=19.419,P=0.000]. In women with a definite diagnosis of cervical insufficiency, full-term delivery rate [44.7% (117/262) vs 20.9% (34/163),χ2=24.844,P=0.000], and newborn body weight were significantly higher in the surgical group [(2 664.3±762.2) vs (2 416.9±845.0) g,t=1.160,P=0.014] than in the expectant treatment group and the late abortion rate was significantly lower [21.4% (56/262) vs 41.1% (67/163),χ2=19.021,P=0.000]. Cervical cerclage in the indefinite diagnosis group did not resulted in raising the full-term delivery rate [28.4% (27/95) vs 35.3% (12/34),χ2=0.561], preterm delivery rate [46.3%(44/95) vs 29.4% (10/34),χ2=2.940], late abortion rate [25.3% (24/95) vs 35.3% (12/34),χ2=1.252] and newborn body weight [(2 526.5±761.8) vs (2 683.4±725.8) g,t=0.004] compared with expectant treatment group (allP>0.05). Pregnancy outcomes in the surgical treatment group in relation to twin pregnancies were not significantly different in the≥28 weeks delivery rate [81.4% (37/46) vs 69.2% (18/26),χ2=1.156], late abortion rate [19.6% (9/46) vs 30.8% (8/26),χ2=1.156] and newborn birth weight [(2 003.2±621.0) vs (1 807.5±609.4) g, t=0.057] compared with those in the expectant treatment group (allP>0.05).ConclusionsIn accordance with the diagnostic criteria for cervical insufficiency and indications for cervical cerclage in surgical cases, cervical cerclage can effectively improve pregnancy outcome. But cervical cerclage is not recommended in twin pregnancies with cervical insufficiency.

Objective To evaluate effects of autologous cytokine-induced killer cell (CIK) transfusion on the survival and hepatitics B virus (HBV) reactivation after radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE).Methods A retrospective analysis was conducted on 185 patients with hepatocellular carcinoma treated from Mar 2007 to Oct 2013.Patients were divided into study group (RFA,TACE,CIK) of 98 cases and control group (RFA,TACE) of 87 cases.According to tumor size,numbers and vascular invasion,patients were stratified into 4 subgroups:the high and the low risk group respectively with tumor ≤ 5 cm and ＞ 5 cm.Results The 1-,3-,5-year survival rate between study and control group were not significantly different:75.5％ (74/98),57.1％ (56/98),20.4％ (20/98) vs.71.2％ (62/87),54.0％ (47/87),21.8％ (19/87) (P ＞ 0.05).Only the study group's 1-,3-,5-year survival rate of high risk patients with tumor ≤ 5 cm were higher than the control group:75.0％ (21/28),53.6％ (15/28),35.7 ％ (10/28) vs.61.9％ (13/21),42.9％ (9/21),23.5％ (5/21) (P ＜ 0.05).The incidence of HBV reactivation was lower in dunantiviral patients who received CIK therapy than those who had 6.0％ (3/50) vs.23.5％ (12/61) (P ＜ 0.05).Conclusion Postoperative adjuvant CIK therapy with tumor≤5cm after RFA combined with TACE was beneficial to the survival of high risk patients and decreased the risk of HBV reactivation.

Objective To explore the clinical characteristics of monochorionic or dichorionic twin pregnancy and the high-risk factors for selective intrauterine growth restriction.Methods 460 women with twin pregnancy were divided into a monochorionic group and a dichorion group.The related clinical features were compared between the two groups.Logistic regression was used to analyze the high-risk factors for selective intrauterine growth restriction.Results The maternal age,conception way,and mode of delivery differed significantly between the two groups (P ＜ 0.05).There were significant differences in the rates of selective intrauterine growth restriction and preterm premature rupture of membranes (P ＜ 0.05).The neonatal weight (large or small) and the rate of neonatal transfer differed significantly (P ＜ 0.05).Logistic regression showed that gestational age and birth weight were the risk factors.Conclusions The chorionic nature plays an important role in the process and outcomes of maternal pregnancy.Monochorionic pregnancy is a high risk factor for selective intrauterine growth restriction,meaning the major cause of selective intrauterine growth restriction may originate from the placenta,with should be a placenta-derived disease.

Objective:Explore the relationship among maternal age,risk factors and pregnancy outcomes.Methods:All childbirth women in Zhujiang hospital of Southern medical university from January 1,2015 to October 31,2016 were recruited and divided into 4 groups according to age:543 cases(13.76％) in ≤24 years old,1648 cases in 25-29 years old(41.18％),1208 cases in 30-34 years old(30.61％),547 cases in ≥35 years old (13.86％).Data of 4 groups about pregnancy complications and outcomes were collected.Set group 20-29 years old as the control group(OR =1).Use x 2 test and binary-logistic regression to analyze data.Results:The elder groups had a higher rate in pregnancy complications and abnormal neonatal situation compared to other age groups.The group ≤24 years old and the group in 30-34 years old had a higher risk on preeclampsia and birth defects,respectively.In the group age ＞30 years old,OR ＞ 1 in following items:the histories of abnormal pregnancy,IVF-ET postoperative,pregnancy with uterine fibroid,gestationaldiabetes and scar uterus,and with the increase of age,the OR value increased.In the group age ＞50 years old,OR ＞ 1 in placenta previa,multiple pregnancy and postpartum hemorrhage,macroscopic delivery and low birth weight,premature infants.In the group 30-34 years old,OR ＞ 1 in birth detects.Conclusions:Different specific targeted examinations and health care work should be taken to pregnant women according to the age.Intervention for high risk factors,active treatment related to congenital disorders and prevention of complications are needed to timely choose the best way of delivery,comprehensive security maternal and child health.

Objective:Explore the relationship among maternal age,risk factors and pregnancy outcomes.Methods:All childbirth women in Zhujiang hospital of Southern medical university from January 1,2015 to October 31,2016 were recruited and divided into 4 groups according to age:543 cases(13.76％) in ≤24 years old,1648 cases in 25-29 years old(41.18％),1208 cases in 30-34 years old(30.61％),547 cases in ≥35 years old (13.86％).Data of 4 groups about pregnancy complications and outcomes were collected.Set group 20-29 years old as the control group(OR =1).Use x 2 test and binary-logistic regression to analyze data.Results:The elder groups had a higher rate in pregnancy complications and abnormal neonatal situation compared to other age groups.The group ≤24 years old and the group in 30-34 years old had a higher risk on preeclampsia and birth defects,respectively.In the group age ＞30 years old,OR ＞ 1 in following items:the histories of abnormal pregnancy,IVF-ET postoperative,pregnancy with uterine fibroid,gestationaldiabetes and scar uterus,and with the increase of age,the OR value increased.In the group age ＞50 years old,OR ＞ 1 in placenta previa,multiple pregnancy and postpartum hemorrhage,macroscopic delivery and low birth weight,premature infants.In the group 30-34 years old,OR ＞ 1 in birth detects.Conclusions:Different specific targeted examinations and health care work should be taken to pregnant women according to the age.Intervention for high risk factors,active treatment related to congenital disorders and prevention of complications are needed to timely choose the best way of delivery,comprehensive security maternal and child health.

Objective To investigate the impact of hepatectomy combined with splenectomy on hepatitis B virus (HBV) reactivation in patients with hepatocellular carcinoma (HCC) ≤5 cm and with hypersplenism.Methods This is a retrospective case-control study on 167 patients with HCC ≤5 cm and with hypersplenism who underwent hepatectomy combined with splenectomy at the Shengli Oilfield Central Hospital between May 2008 and June 2015.64 patients underwent hepatectomy combined with splenectomy,and 103 patients hepatectomy alone.The patients were assigned to the hepatectomy combined with splenectomy group (the combined group,n =61) or the hepatectomy alone group (the control group,n =61) using propensity score matching (PSM).Logistic regression was used to evaluate the relative clinical factors associated with HBV reactivation.The stratified Chi-squared test was utilized to determine the impact of the surgical procedure and preoperative anti-viral therapy on postoperative hepatitis B virus reactivation of these patients.Results The serum PLT level,Child-Pugh grading,tumor diameter and surgical procedures were shown to be independent risk factors associated with postoperative HBV reactivation (P ＜ 0.05).To study the impact of preoperative anti-viral therapy on postoperative HBV reactivation:-the incidence of HBV reactivation was higher in the control group than in the combined group (19.7％ vs.6.6％,P ＜ 0.05).In the combined group,there was no significant difference between patients who received anti-viral therapy and those who were treatment-naive (5.3％ vs.7.1％,P ＞0.05).In the control group,a higher incidence of HBV reactivation was found in patients with treatment-na(i)ve than in patients who received anti-viral therapy (26.1 ％ vs.0,P ＜ 0.05).For the patients who received anti-viral therapy,there was no significant difference between the combined group and the control group (5.3％ vs.0,P ＞ 0.05).In patients with treatment-na(i)ve,a higher incidence of HBV reactivation was observed in the control group than the combined group (26.1％ vs.7.1％,P ＜ 0.05).Conclusions In patients who were not treated with antiviral therapy,hepatectomy combined with splenectomy decreased the incidence of postoperative HBV reactivation in patient with HCC ≤5 cm and with hypersplenism.For the patients who received preoperative anti-viral therapy,the incidence of postoperative HBV reactivation was not decreased with hepatectomy combined with splenectomy.

Objective To evaluate effect of dexmedetomidine on mitochondrion-dependent apoptosis during hypoxia-reoxygenation (H/R) injury to hippocampal neurons of rats.Methods The primarily cultured hippocampal neurons of Sprague-Dawley rats were divided into 4 groups (n =40 each) using a random number table method:control group (C group),vehicle group (V group),H/R group and dexmedetomidine group (D group).Hippocampal neurons were subjected to oxygen-glucose deprivation followed by restoration of oxygen supply to establish the model of H/R injury.Dexmedetomidine 1 μmol/L was added at 6 h of reoxygenation in D group.The viability of neurons was measured by methyl thiazolyl tetrazolium assay at 20 h of reoxygenation.The ultrastructure of mitochondria was observed by transmission electron microscopy.The expression of cytochrome c (Cyt c),caspase-3,Fis1 and Drp1 was detected by Western blot.The neuronal apoptosis was detected by flow cytometry,and apoptosis rate was calculated.Results Compared with C group,no significant change was found in the viability of neurons in group V (P＞0.05),and the viability of neurons was significantly decreased,the apoptosis rate was increased,the expression of Cyt c,caspase-3,Fis1 and Drp1 was up-regulated (P＜0.05),and the damage to mitochondrial ultrastructure was accentuated in H/R and D groups.Compared with H/R group,the viability of neurons was significantly increased,the apoptosis rate was decreased,the expression of Cyt c,caspase-3,Fis1 and Drp1 was down-regulated (P＜0.05),and the damage to mitochondrial ultrastructure was significantly attenuated in D group.Conclusion The nechanism by which dexmedetomidine reduces the H/R injury to hippocampal neurons is related to inhibiting mitochondrion-dependent apoptosis in rats.