Objective To study the relationship of placental expression of leptin and disease development in patients with pre-eclampsia.Methods The placental expression of leptin gene was determined in gestational hypertension(10 cases),mild pre-eclampsia(10 cases),Severe pre-eclampsia(10cases)and normal pregnant women(15 cases,control group)by reverse txanscription/polymerase chain reaction(RT/PCR).Meanwhile,24 hour urine protein and mean arterial blood pressure(MAP)were detected in patients with pre-eclampsia.Results The expression of leptin mRNA in placenta were significantly higher in severe and mild pre-eclarnpsia than that in normal pregnant women(0.507 ±0.036,0.476±0.023vs 0.441 ±0.030)(P＜0.01),meanwhile,in the severe pre-eclampsia was higher than that in the mild preeclampsia(P＜0.05).The difference was not significant between the gestafional hypertension(0.463±0.024)and the normal pregnant women(P＞0.05).There was a positive correlation between the placental leptin mRNA expression levels in pre-eclampsia and the 24 hour urine protein and MAP (P＜0.05).Conclusions The placental leptin mRNA expression levels in pre-eclampsia increase.The pre-eclampsia women placental hptin mRNA expression levels correlate with pathogenetie condition.The placental leptin mRNA expression levels in pre-eclampsia correlate,with disease development.

AIM: To investigate the influence of tumor necrosis factor ?(TNF ?) or angiotensin Ⅱ(Ang Ⅱ) on tissue factor(TF) gene expression and the regulatory effect of upstream sequence on TNF ? or Ang Ⅱ-induced TF gene transcription in human vascular endothelial cells.METHODS: TF mRNA in endothelial cells was analyzed by in situ hybridization. By means of gene recombinant technique, we constructed two luciferase reporter genes containing different upstream sequence of TF gene. The two luciferase reporter genes, together with the intracontrol plasmid pSV-?-gal were co-transfected respectively into cultured human vascular endothelial cells. The relative luciferase activities were detected.RESULTS: TNF? or Ang Ⅱ could increase the expression of TF mRNA in vascular endothelial cells. TNF? and AngⅡ could significantly increase the luciferase expression in the p-244/+121bp Luc transfected endothelial cells, respectively. The luciferase expression in the p-111/+121bp Luc transfected endothelial cells decreased significantly compared with that in the p-244/+121 bp Luc transfected endothelial cells and there was no significant difference compared with control group. CONCLUSION: Upstream sequence p-244/-112bp of TF gene may play an important regulatory role in TNF ? or AngⅡ-induced TF gene expression in human vascular endothelial cells.

To study the effects of Liangxue Jiedu Decoction, a compound traditional Chinese herbal medicine with the function of blood-cooling and detoxicating, in treating psoriasis in mice and to explore its mechanism.

BACKGROUND: It is commonly thought that the expression of tissue factor (TF) gene in human umbilical vein endothelial cells (HUVECs) could be induced by tumor necrosis factor(TNF-α) . But the intervention effect of monomer extract of radix salviae miltiorrhizae(764-3) on TF expression in duced by TNF-α in endothelial cells has not been reported and the mechanism is still unclear.OBJECTIVE: To investigate the intervention effect of 764 - 3 on TF expression and calcium ion( [Ca2+] i) induced by TNF-α in HUVECs so as to probe into the possible mechanism of 764 - 3 for preventing cardiovascular thromboembolic diseaseDESIGN: Randomized and controlled trial.SETTING: Laboratory of Department of Pathophysiology, Institute of Basic Medical Sciences, Peking Union Medical College MATERIALS: This study was conducted in the Department of Pathophysiology, Institute of Basic Medical Science, Peking Union Medical College,Chinese Academy of Medical Sciences from May 1998 to September 1999. Umbilical cord was chosen from Beijing Obstetrics and Gynecology Hospital.INTERVENTIONS: ECV304 cell strain and HUVECs were cultured in vitro. With gene recombination techniques, two luciferase reporter genes containing different length of human TF gene promoter were constructed. The two-luciferase reporter genes, together with the intracontrol plasmid pSV-3-gal were respectively cotransfected into cultured ECV304 and HUVECs.MAIN OUTCOME MEASURES: The activities of luciferase and βgalactosidase were detected in ECV304 and HUVECs treated by TNF-α or/and 764 -3. Taking Fluo- 3/AM as fluorescent indicator, [Ca2+]i in single HUVEC was observed with laser-scanning confocal microscope.RESULTS: The luciferase expression in the p - 244/ + 121 bp luc transfected endothelial cells was significantly increased when the cells were exposed to 100 U/mL TNF-α. The induction of TNF-α could be inhibited by 764 -3 ( P ＜ 0.05). The luciferaseexpression in the p - 111/+ 121 bp Luc transfected endothelial cells was significantly lower than that in the p - 244/+ 121 bp ones and at the same time, 764 -3 did not cause the significantly change of the luciferase expression. Under laser-scanning confocal microscope, TNF-α increased [Ca2 +] i in single HUVEC, but the effect was inhibited by 764 - 3.CONCLUSION: TF gene expression induced by TNF-α was inhibited by 764 - 3 in endothelial cells, which was dependent on the p-244/+ 121 bp,and [Ca2+ ]; might be involved in it.

OBJECTIVE To investigate the clinic significance of screening high risk human papillona virus DNA(HR-HPV-DNA) in pregnant and postpartum women.METHODS HR-HPV-DNA screening was carried by HC-Ⅱ in 711 pregnant and postpartum women.RESULTS In 711 specimens,the infection rate of HR-HPV was 15.07%,15.92% in pregnant women,and 10.11% in postpartum ones;13.43% in the group

Objective Probing into the changes of medical expenses by medical institutions for references to harnessing such expenses.Methods By means of the time sequence method,analyzing the dynamic changes of medical expenses of district of Beijing from 2004 to 2007,with a comparison for hospitals by levels.Results The study found that between 2004 and 2007,the medical expense per person of outpatients in 26 hospitals fell from 72.73 yuan to 70.09,with a relative ratio with a fixed base being-3.64%;the hospitalization expense per capital rose to 3044.35 yuan,with the same ratio being 13.15%;the percentage of pharmaceuticals sales among total income fell from 40.56% to 40.03%.Conclusions It is feasible to harness the rapid growth of medical expenses by means of normalizing medical charges,restricting the percentage of pharmaceuticals among total expense,improving hospital services at all levels,and promoting health education and health itself.

Objective:To explore the risk factors of spontaneous rupture of hepatocellular carcinoma (HCC), and to analyze the prognosis of transcatheter arterial embolization (TAE) in the treatment of spontaneous rupture of HCC.Methods:From January 2008 to December 2018, at Tianjin Third Central Hospital, 126 patients diagnosed with spontaneous rupture of HCC (spontaneous rupture group) and in the same period 252 patients diagnosed as HCC without rupture (non-spontaneous rupture group) were retrospectively selected. Independent sample t test, Mann-Whitney U test and chi-square test were used to compare the general data, laboratory test results and imaging results between spontaneous rupture group and non-spontaneous rupture group. Multivariate logistic regression was used to analyze the independent risk factors of spontaneous rupture of HCC. Kaplan-Meier method and log-rank test were used for survival analysis of 92 patients treated with TAE and 31 patients treated with conservative treatment in patients with spontaneous rupture of HCC, and multivariate Cox proportional hazard regression was used to analyze the independent prognostic factors of patients treated with TAE. Results:The proportions of tumor maximum diameter ≥5 cm, tumors mainly located in segment Ⅱ, Ⅲ, Ⅳ and Ⅵ of the liver, tumors protruding height from the surface of liver ≥1 cm, liver cirrhosis and portal vein thrombosis (PVT) in spontaneous rupture group were all higher than those in non-spontaneous rupture group (46.8%, 59/126 vs. 35.7%, 90/252; 61.1%, 77/126 vs. 46.0%, 116/252; 73.0%, 92/126 vs. 18.7%, 47/252; 81.7%, 103/126 vs. 69.0%, 174/252; 20.6%, 26/126 vs. 11.5%, 29/252), and the level of fibrinogen is lower than that in non-spontaneous rupture group ((3.07 ±1.38) g/L vs. (3.92±1.13) g/L), and the differences were statistically significant ( χ2=4.343, 7.644, 106.780, 6.918 and 5.628, t=-3.276, all P<0.05). The results of multivariate logistic regression analysis showed that the location of tumors in segment Ⅱ, Ⅲ, Ⅳ, Ⅵ of the liver, the height of tumors protruding from the surface of liver ≥1 cm, liver cirrhosis and the fibrinogen was lower than the lower limit of the reference value were independent risk factors of spontaneous rupture of HCC (odds ratio ( OR)=1.354, 5.726, 1.152, 1.892; 95% confidence interval ( CI) 1.062 to 2.008, 1.049 to 19.575, 1.016 to 1.895, 1.267 to 3.346; all P<0.05). Among 92 patients with spontaneous rupture of HCC treated with TAE, the TAE technical success rate and clinical success rate were 100.0% (92/92) and 93.5% (86/92), respectively. Thirty-one patients received conservative treatment. The median survival time of the patients treated with TAE was 243 d (38 d, 377 d), which was about 10 times that of the patients who accepted conservative treatment (23 d (9 d, 51 d)). The 1-month, 3-month, 6-month, 1-year and 3-year survival rates of the patients treated with TAE were 72.8%, 50.8%, 46.0%, 31.1% and 13.6%, respectively, and those of patients who accepted conservative treatment were 25.8%, 17.2%, 11.5%, 5.7% and 0, respectively; and the differences in survival rates between the two groups were statistically significant ( χ2=34.606, P<0.01). Log-rank test analysis showed that initial hemoglobin <60 g/L, C grade of liver function, total bilirubin (TBil)≥50 μmol/L, complicated with portal vein tumor thrombus, hepatic lobe embolism during TAE, and tumor maximum diameter ≥10 cm were all correlated with poor survival rates of patients with spontaneous rupture of HCC after TAE ( χ2=3.752, 4.146, 22.318, 4.087, 5.685 and 7.893, all P<0.05). The results of multivariate Cox proportional hazard regression analysis showed that TBil ≥ 50 μmol/L, hepatic lobe embolism during TAE, and tumor maximum diameter ≥10 cm were independent factors of poor prognosis of spontaneous rupture of HCC treated with TAE ( OR=25.873, 8.415, 18.620; 95% CI 4.916 to 126.005, 1.136 to 27.319, 2.754 to 84.368; all P<0.05). Conclusions:In HCC patients with tumors located in segments Ⅱ, Ⅲ, Ⅳ and Ⅵ of the liver, the height of tumors protruding from the surface of liver ≥1 cm, liver cirrhosis or the fibrinogen is lower than the lower limit of the reference value, close attention should be paid to the risk of spontaneous tumor rupture. TAE is an effective treatment for acute spontaneous rupture of HCC, and the prognosis of patients treated with TAE is better than that of patients receiving conservative treatment. However, patients with TBil ≥50 μmol/L, hepatic lobe embolism during TAE and tumor maximum diameter ≥10 cm have a poor prognosis after TAE treatment.

Objective To investigate the value of intraoperative contrast-enhanced ultrasound(CEUS) in evaluating pathological grades of cerebral gliomas. Methods Intraoperative CEUS was performed in 33 patients of cerebral gliomas of different pathological grades. Real-time blood perfusion and enhance characteristics of these tumors were observed,quantitative parameters from the automatically derived time-intensity curve (TIC) were obtained, and compared with the tumor microvessel density (MVD) by immunostaining with anti-CD34. Results The time to peak was significantly shorter and the MVD was significantly higher in the high grade cerebral gliomas compared with the low grade ones ( P <0. 05). The time to peak was negatively correlated with the MVD by immunostaining (r = -0.79, P < 0. 05). Conclusions Intraoperative CEUS could be used to observe microvascular perfusion in real-time, and could indirectly reflect the information of MVD in cerebral gliomas, which is of help to grade cerebral gliomas and guide surgical resections.

Objective To discuss the significance of social psychological medical humanities pro-fessional skills training in the resident standardization training. Methods Choosing 138 people to attend the training in 17 resident standardization training in Hubei University of Medical,and carrying out medical humanities professional skills training by the form of questionnaire, comparing social psychological profes-sional skills training rules before and after the doctor cognitive situation of the doctor-patient relationship, the grasped social psychological professional skills, doctor-patient communication skills assessment, assess-ment of objective structured clinical examination results and the professional knowledge. Results ①The cognitive situation of the doctor-patient relationship in a survey showed that 56.5% (78/138) patients after training of physicians thought that they are short of doctor-patient communication skills, 66.7% (92/138) believe that good communication skills was the most important skills,differences were statistical significance (P<0.05).②The comparison of the grasped social psychological professional skills showed that 86.2% of the doctors thought inquiry need to listen to every patients,79.8% thought it necessary to build a good commu-nication atmosphere,87.7% thought training could improve the communication skills,79.8% thought resident standardization training was the best stage of social psychological professional skills training,The difference before and after training was statistically significant (P<0.05). ③SEGUE questionnaire scores showed that after training physician training of doctor-patient communication was significantly higher than before,having statistically significant differences (P<0.01). ④OSCE score showed that after training, the total score and each passing rate (60 points) were higher than those before training. ⑤Before and after the training, there were significant differences in physician skill examination in the part of written examination, skill operation and interview score(P<0.05).Conclusions The resident standardization training follows the law of medical education and medical personnel training, strengthens the training of doctors' social psychological skills, and promotes the ability and level of medical service,which is worthy to be popularized.

Clinical skill competition based on objective structured clinical examination could evalu-ate students' clinical abilities effectively and fairly in a comprehensive way. The competition results not only reflected the learning effectiveness of the competitors but all the medical students. Analysis and exploration of the inspiration from the competition could promot the all-round development of students and boost the continuous growth and progress of clinical teaching.