Objective To compare the difference of pregnancy outcomes between women who had a history of recurrent spontaneous abortion ( RSA) and women who were primigravida. Methods A case-control study was carried out. A total of 98 cases with a history of RSA and giving birth in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January of 2010 to September of 2014 served as the case group, while 98 primigravida giving birth at the same period in the same hospital were randomly selected as controls. The information collection form was designed following literature review before the research. All of the available data, including maternal demographic, reproductive information, medical history and present pregnancy outcomes, were collected from in-patient medical records. The number of valid information forms in case group was 91 and was 94 in control group after excluding the forms with incomplete data. The data was analyzed with SPSS 16.0 software. Results Univariate analysis results showed that maternal age, marital status, distribution of ABO blood groups, the history of infertility, clinical manifestation of threaten abortion, miscarriage treatment during pregnancy, medication of Zishen Yutai Pills for preventing miscarriage, time of delivery, adverse pregnancy outcome, and newborn sex were statistically significant different between the two groups ( P<0.05) . Logistic regression analysis results showed that there were significant differences in 5 factors between the two groups. Maternal age ( OR=1.466, 95%CI=1.267-1.698) , medication of Zishen Yutai Pills for preventing miscarriage ( OR=4.484, 95%CI=1.073-18.519) , and adverse pregnancy outcome ( OR=8.850, 95%CI=2.994-26.316) were the risk factors of RSA. Set blood type O as the classification reference, blood type A was a protective factor ( OR=0.259, 95%CI=0.088-0.765). And newborn sex was another protective factor of RSA ( OR=0.336, 95%CI=0.139-0.813). Conclusion Older women or women with blood type O are more likely to suffer from RSA than women with blood type A. Comparing with primigravida, women who had a history of RSA are more willing to accept medication of Zishen Yutai Pills for miscarriage, and women giving birth of a boy are more likely to have RSA and thereatened abortion, having high risk of adverse pregnancy outcomes particularly for the increase of gestational diabetes incidence.

Objective To explore the effect of BCG-polysaccharide nucleic acid(BCG-PSN) on the numbers of Th3,Th2 and Th1 cells in peripheral blood mononuclear cell(PBMC) and airway inflammation status in patients with asthma.Methods Twenty-six patients with moderate persistent asthma were enrolled into the study and randomly divided into simple medication group(n=13,accepted Fluticasone/salmeterol alone) and combined medication group(n=13,accepted Fluticasone/salmeterol+BCG-PSN together).The numbers of Th3,Th1 and Th2 cells in PBMC, the serum levels of TGF-β,IFN-γ,IL-4 and IgE and the clinical effect and airway inflammation status were observed at three time points: before,1.5 months after and 3 months after treatment. Results (1)At 1.5 months after treatment,the Th1/Th2 number was significantly higher in the combined medication group than the simple medication group(1.20±0.57 vs 0.79±0.39,t= 2.129,P＜0.05),and the asthma control test scale(ACT) showed similar difference(18.31±1.75 vs.15.54±2.40,t=3.359,P＜0.01) between the two groups.(2)At 3 months after treatment,the Th1/Th2 number was significantly higher in the combined medication group than the simple medication group(1.73±0.74 vs1.16±0.48,t=2.327,P＜0.05),and the ACT also showed the same kind of difference(22.46±1.13 vs.20.23±2.59,t=2.851,P＜0.01) between the two groups.In addition,at this time point the PEF variability was significant lower in the combined medication group than the simple medication group([9.88±2.18]% vs.[12.05±2.74]%,t=2.235,P＜0.05).(3)We found no significant differences in the comparisons of the numbers of T helper cell subsets in PBMC ,the serum levels of cytokines and IgE,the numbers of inflammatory cells in induced sputum between the two groups(Ps＞0.05).(4)No correlation were found between Th3 cell numbers in PBMC and the serum levels of IgE in the two groups.Conclusion The combined use of Fluticasone/salmeterol and BCG-PSN can further correct the imbalance of Th1/Th2 cells,alleviate clinical symptom of asthma and airway hyper-responsiveness.The therapeutic efficacy improves along with the therapy period,better in the combined medication group than the simple medication group.BCG-PSN has no significant effects on the numbers of Th3 in PBMC in patients with asthma.

OBJECTIVE To analyze the characteristics of nosocomial infections,risk factors and prevention measures in patients with chronic severe hepatitis B.METHODS A retrospective review of the medical records of 354 patients with chronic severe hepatitis B admitted between Jan 2006 and Dec 2006 was performed.RESULTS The incidence of nosocomial infection in patients with chronic severe hepatitis B was 16.67% and mainly infection sites consisted of abdominal cavity(40.32%),and upper respiratory tract(22.58%).The most common infection(47.46%) was occurred during the period of hospitalization 15-30 days after and the most commonly pathogens were Gram-negative bacilli(68.75%).The infection risk factors were associated with invasive operation,hypoalbuminemia,endotoxemia,advanced age,antibiotics application and decrease in cell immune function.CONCLUSIONS It is important for the patients with chronic severe hepatitis B to strengthen management on related risk factors in order to prevent nosocomial infection effectively.

Objective To observe the effect of ephedrine on the expression of eotaxin in human bronchial epithelial cells (16HBE) stimulated by tumor necrosis factor‐α(TNF‐α) and to explore the mechanism of Chinese medicine ephedra in treating asthma .Methods The in vitro cultured 16HBE were randomly divided into the control group ,TNF‐αstimulation group(TNF‐α20 ng/mL) and TNF‐αplus ephedrine group (TNF‐α20 ng/mL plus ephedrine 300 μg/mL) .Three complex holes in each group were set to culture for 18 h ,the eotaxin mRNA expression was measured by real time fluorescent quantified PCR and protein level was detected by immunocytochemical stain and Western blot .The eotaxin concentration in cells culture supernatant was quantified by ELISA .Results Compared with the the control group ,the expression level of eotaxin mRNA and protein ,and the concentration of eotaxin in cell culture supernatant in the TNF‐α stimulation group were increased obviously ,there being statisticaly significant difference between them(P<0 .01);however ,all above these parameters in the TNF‐αplus ephedrine group showed decreased obvi‐ously as compared with the TNF‐αgroup ,the difference between them was statistically significant (P<0 .01) .Conclusion Ephed‐rine can inhibit the expression and secretion of eotaxin in TNF‐α induced 16HBE inflammatory model ,which may be one of the mechanisms of Chinese medicine ephedra in treating asthma .

BACKGROUND:Adult cardiomyocytes show no regenerative ability, and celltherapy for myocardial regeneration and repair may improve myocardial ischemic injury function. OBJECTIVE:To confirm the effect and reveal the mechanism of bone marrow mesenchymal stem cells (BMSCs) on acute myocardial infarction (AMI). METHODS:BMSCs were isolated, cultured from bone marrow of Sprague-Dawley rats using density gradient centrifugation. AMI models were produced in 20 rats by ligating the left anterior descending (LAD) coronary artery, and randomly divided into model group and BMSCs group. In the BMSCs group, cells were subsequently injected with a sterile microinjection via the tail vein. RESULTS AND CONCLUSION:Six months postoperatively, the cardiac function was improved, the vessel density was increased, the percentage of apoptotic cells was decreased in the BMSCs group than that in the model group;the expression levels of inflammatory factors, including vascular endothelial growth factor, von Wil ebrand factor, transforming growth factor 3β, and interleukin-1βmRNA were significantly improved in the BMSCs group than that in the model group. These results showed that BMSCs can protect the myocardium from AMI by regulating the secretion of inflammatory cytokines and angiogenic factors.

The number of taking the Examination of Doctor Qualification is rising,while the pass rate is dropping each year.This status has undoubtedly made a big challenge for clinical teaching,and how to improve the effects of clinical lessons has become an important topic for the clinical teachers.The Affiliated Xinqiao Hospital of the Third Military Medical University has made some new changes in clinical teaching mode,which has a study clue of organ and system.Those methods give much help for students to pass the Examination of Doctor Qualification.

Objective To analyze the risk factors for the failure of noninvasive mechanical ventilation (NIV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to help the clinical risk assessment and decision making.Methods A retrospective case control study was conducted.The patients with AECOPD undergoing NIV admitted to Kaifeng Emergency Center from June 2011 to March 2016 were enrolled,and they were divided into two groups according to whether NIV was successful or not within 12 hours.The nutritional status,blood gas analysis,serum electrolytes,D-dimer,renal function,serum pre-albumin,as well as kinetic vital signs,Glasgow coma scale (GCS) score,expression of respiratory distress,and spontaneous expectoration were recorded.Logistic forward stepwise regression analysis was used to analyze the factors for failure of NIV.Results 122 patients.with the initial NIV were enrolled,with NIV failure in 41 patients within 12 hours,accounted for 33.6％.Compared with NIV success group,the percents of respiratory rate ≥ 25 breaths/min (75.6％ vs.17.3％),expectoration disorders (78.0％ vs.19.8％),circulatory disorders (61.0％ vs.18.5％),malnutrition (61.0％ vs.11.1％),decreased serum pre-albumin (58.5％ vs.17.3％),and GCS score ＜ 12 (75.6％ vs.28.4％) in NIV failure group were significantly increased (all P ＜ 0.05).But there were no significant differences in gender,age,body temperature,blood gas analysis,D-dimer,serum creatinine between two groups.It was shown by the results of binary logistic regression analysis that respiratory rate,expectoration disorders,circulatory disorders,malnutrition,serum pre-albumin,and GCS score were the factors of NIV failure [odds ratio (OR) values were 10.879,6.338,9.860,23.273,8.862,6.774,and P values were 0.011,0.038,0.024,0.003,0.015,0.041,respectively].It was shown by the results of logistic stepwise regression analysis that respiratory rate ≥ 25 breaths/min,expectoration disorders,circulatory disorders,malnutrition,decreased serum pre-albumin,and GCS score ＜ 12 were independent risk factors of NIV failure (OR values were 6.610,5.403,5.138,8.153,4.979,5.100,and P values were 0.007,0.013,0.023,0.007,0.027,0.023,respectively).Conclusions The multiple independent risk factors can induce NIV failure within 12 hours in emergency patients with AECOPD,i.e.increased respiratory rate,expectoration dysfunction,circulatory disorders,malnutrition,decreased serum pre-albumin,and decreased GCS score.Emergency physicians should pay attention to these early risk factors in AECOPD patients,which can be taken as correct judgment and guide.

Objective To investigate the dynamic changes and its significance of inflammatory factors in cervical secretions and prior cervical tissues after cervical conical resection.Methods Women who received prior cervical conization during December 2013 and December 2015 in this hospital were selected,then the cervical tissue and secretion were collected regular interval after the conization.The expression of tumor necrosis factor-α(TNF),interleukin 6 (IL-6) and high mobility group protein 1 (HMGB1) were quantitative detected and analyzed.The expression and infiltration of inflammatory cell were detected by HE and immunohistochemical staining.Results The expression of TNF-α,IL-6 and HMGB1 in cervical tissues and secretions increased gradually after priorcervical conization,which reached the peak at 1 to 2 weeks after priorcervical conization,and then gradually decreased,the differences were statistically significant when compared with the preoperative control group (P＜0.05).The inflammatory cell infiltration and the inflammatory response were most severe at 1st week after the conization.The expression of TNF-α,IL 6 and HMGB1 was at 1st week after the conization were significantly higher than that of the 4thweek group.Conclusion The cervical inflammatory were most severe after the prior cervical conization about 1-2weeks,and the hysterectomy should be avoided at this stage.

The antinociceptive effect of epidural administration of huwentoxin-I was elucidated in a tonic visceral pain rat model produced by acute colon inflammation. The nociceptive behaviors were induced by perendoscopically injecting dilute formalin (50 μl) into the depth of the colonic wall in rats. Both ω-conotoxinMVIIA and morphine hydrochloride were given epidurally as positive control while saline as negative control.Similar to ω-conotoxin-MVIIA and hydrochloride morphine, the epidural administration of HWTX-Ⅰ significantly reduced the nociceptive responses in a dose-dependent manner in tonic visceral pain rat model ( P ＜ 0.05). The suppression effects of both huwentoxin- Ⅰ and ω-conotoxin-MVIIA at 20 μg/kg were kept steady compared with the saline group and reached their maximum effects at the doses of 50 ～ 75 μg/kg within 1 hour when the nociception had been observed. It was also found that at the same doses, huwentoxin- Ⅰ was less effective in antinociception than ω-conotoxin-MVIIA. However, ω-conotoxin-MVIIA, but not huwentoxinⅠ , caused an obvious motor dysfunction at these doses. The action of morphine hydrochloride was initiated faster, but lasted for a shorter time than that of huwentoxin- Ⅰ and ω-conotoxin-MVIIA. Thus, huwentoxinⅠ , a potent blocker of neuronal N-type voltage-sensitive calcium channels, induced a remarkable dosedependent restrain effect similar to ω-conotoxin-MVIIA and morphine on the tonic visceral pain produced by colonic wall injection of formalin in conscious rats.

Dorsal root ganglion (DRG) neurons are primary sensory neurons that conduct neuronal impulses related to pain, touch and temperature senses. To comprehensively identify proteins of plasma membrane (PM) from small amount of dorsal root ganglion (DRG) neurons, a proteomics strategy that utilizes aqueous polymer two-phase partition in combination with differential velocity centrifugation was adopted to enrich the PM, followed by SDS-PAGE, CapLC-MS/MS and bioinformatics analysis. Western blot analysis showed that the concentration of PM in purified plasma membrane(PPM) was 2.3 times higher than that in crude plasma membrane(CPM), 15 times higher than that in whole tissue lysate (WTL). By searching against the rat IPI protein sequence database, a total of 729 non-redundant proteins were identified from the PM preparation, of which 547 had a gene ontology (GO) annotation indicating a cellular component, and 159 (21.8%) were unambiguously identified as PM proteins. A data set of plasma membrane proteins of DRG as well as a tool to study PM proteins were provided in a small amounts of sample.