Objective Severe preeclampsia (sPE), which is usually complicated by small-for-gestational-age (SGA) and immature labor , remains a leading cause of maternal and neonatal mortality and morbidity. This study was to investigate the risk factors of SGA in sPE. Methods We retrospectively analyzed 100 cases of sPE, 35 with SGA (the case group) and the other 65 without it ( the control group ) .We conducted single-factor analysis on the general characteristics and potential impact factors of the patients , i-dentified the independent risk factors of SGA using the un-conditional stepwise logistic model , and assessed the value of umbilical arter-y S/D ratio and proteinuria ration in the diagnosis of sPE with SGA with the ROC curve . Results Compared with the control group , the case group had more cases of early-onset sPE ( P =0.010 ), earlier gestational and delivery weeks (P<0.001), lower neonatal weight at birth ( P<0 .001 ) , higher rate of admission to and longer stay in the neonatal ICU (P<0.001), and higher incidence of neo-natal complications (P<0.05).The case group also showed signifi-cant increases in comparison with the control in the umbilical artery S/D ratio (2.95 ±0.75 vs 2.31 ±0.47, P<0.05), frequency of S/D ratio ≥95th percentile (22.86% vs 6.15%, P<0.01), and rate of proteinuria ≥5 g/24 h (42.86% vs 20.00%, P<0.05).The S/D ratio ≥95th percentile (OR=6.02, 95%CI:2.32-16.78) and proteinuria≥5 g/24 h (OR=1.65, 95%CI:1.56-3.01) were found to be the risk factors of sPE with SGA.The area under the curve was 0.852 for the combination of S/D ra-tio and proteinuria ration in the diagnosis of sPE with SGA (P<0.05). Conclusion Umbilical artery S/D ratio≥95th percentile and proteinuria ≥5 g/24 h contribute to the early prediction, prevention, and prognosis of sPE, and is valuable for the diagnosis of sPE with SGA.

Blood-brain barrier (BBB) injury is an important pathological change of ischemic stroke.Occludin constitutes the major component of the tight junction of BBB, which plays a significant role in maintaining the BBB integrity.Cerebral ischemia initiates occludin degradation through the induction of the activation of inflammatory mediators, reactive oxygen, and matrix metalloproteinases, and causes the changes of tight junction cytoskeletal protein interaction, resulting in BBB integrity destruction and increased permeability.This article mainly elaborates the relationships of occludin with BBB, brain edema and hemorrhagic transformation, as well as the possibility of occludin as an intervention target for ischemic stroke.

Hemorrhagic transformation(HT) is the most severe complication after tissue-type plasminogen activator (tPA) thrombolysis. It greatly limits the clinical application of tPA. Early blood-brain barrier ( BBB) damage may be an important mechanism for HT. Maintaining the integrity of BBB can significantly decrease the risk of HT. This article review s the roles, mechanisms, and preventive measure of early BBB damage in HT after tPA thrombolysis.

Objective To comparatively study the difference between thromboelastography (TEG)and light transmission ag-gregometry (LTA)in monitoring clopidogrel effect in patients with acute coronary syndrome.Methods 68 patients with a-cute coronary syndrome,who were in hospital from February to December 2013,were enrolled in this study.They received TEG and LTA to determine platelet aggregation.Results Clopidogrel effect was (47.84±26.04)% and (45.64±20.92)%respectively by TEG and LTA.There were negative correlation between LTAADP and TEGADP(r=-0.752,P<0.001),pos-itive correlation between LTAADP and MAADP(r=0.789,P<0.001),negative correlation between TEGADP and MAADP(r=-0.820,P<0.001).Conclusion There was a good correlation between the two methods.TEG can be used to evaluate thera-peutic effect of Clopidogrel effect.

Objective To identify the distribution feature of methylenetetrahydrofolate reductase (M T HFR) gene polymorphism of Buyi ,Dong ,Miao nationality in Guizhou .Methods The MTHFR(677 and 1 298) genotypes of Buyi ,Miao and Dong healthy indi-viduals were determined by TaqMan-MGB probe genotyping method and constructed haplotypes .Results There were significant difference of MTHFR 677C/T genotype and allele frequencies among 3 groups(P<0 .05) ,There was significant difference of geno-type between Buyi and Miao nationality ,and there were significant differences of genotype frequencies in Buyi nationality and Dong and Miao nationality(P<0 .01) .There were no differences of MTHFR 1298A/C genotype frequencies among Buyi ,Dong and Miao nationality(P> 0 .05) .Buyi nationality had the lowest frequency in double wild homozygous type (677CC/1298AA) ,677TT/1298CC double mutation homozygous and 677TT/1298AC combination in above three minorities was not found .There were linkage disequilibrium between 677C/T and 1298A/C in Buyi and Miao nationality .Conclusion The genotypes frequencies of MTHFR 677T T/1298AC are significant differences among different regions and different ethnic groups .

Objective To study the application effectiveness of healthcare failure modes and effects analysis before the secure transportation of post anesthesia care unit(PACU) patients. Methods A total of 689 general anesthesia post-operative patients who had been recovered in PACU and transported between January to December in 2015 by convenience sampling were divided into 2 groups to receive nursed by traditional method before transportation (contrast group, 346 cases) or nursed both with traditional way and healthcare failure modes and effects analysis method to analyze (observation group, 343 cases). The Medical Risk Priority Number (RPN), Status of Failure modes and satisfaction value of physicians and nurses were compared. Results The RPN value of observation group had been cut down from (229.00 ± 52.91) points to (57.14 ± 16.04) points, there was significant difference (t=7.58, P=0.01). The occurrence rate of failure mode of observation group was 2.62%(9/343), which was obviously lower than 19.36%(67/346) of contrast group, there was significant difference (χ2=49.19, P<0.01). The satisfaction rate of observation has improved significantly from 74.36%(58/78) to 93.59%(73/78), there was significant difference (χ2=10.72, P<0.01).Conclusions Healthcare failure modes and effects analysis management method could find out the failure mode of PACU patient before the secure transportation in time, could decrease the effect of failure mode and would continuously improve the quality of PACU nursing service .

Platelet-rich plasma (PRP) is a concentrated source of autologous platelets after centrifugation, being used widely in plastic surgery and oral-maxillofacial surgery. Recent studies have showed that PRP can improve bone repair, vasculogenesis, and soft tissue repair. Composite of PRP and stem cells is applied in the field of orthopedics and tissue engineering. As a matter of fact, PRP has become a hot research topic. In addition, PRP plays an important role in the healing of chronic wound. This paper briefly introduces the main components of PRP and its clinical application, the mechanism for bone healing and soft tissue repair, as well as the latest research achievement and discussion in the shortcoming of PRP in clinical application.

OBJECTIVE: To review the development and mechanism of platelet-rich plasma (PRP) and the unsolved problems so as to provide reference for the clinical application of PRP.DATA SOURCES: Articles on effects of platelet-rich plasma on bone repair are searched from Medline between January 1995 and June 2005 on computer. The key words were platelet rich plasma, bone, and repair.Meanwhile, the same search was conducted to determine the correlated articles during January 1998 to June 2005 from Wanfang database with key words of platelet-rich plasma, bone and repair in Chinese.STUDY SELECTION: Literatures at home and abroad on the PRP and bone repair were chosen; Non-randomized controlled literatures were included.DATA EXTRACTION: Totally 40 out of 49 reports related to PRP and bone repair met the criteria. 9 reports were excluded due to the repeated same research. The rest 40 reports were sorted out and conducted literature review.DATA SYNTHESIS: Platelet-rich plasma was originally used in clinic to repair mandibular defect in 1998, by adding PRP to grafts with a radiographic maturation rate 1.62 to 2.16 times that of grafts without PRP. Up to now, PRP has been used in many medical areas to accelerate tissue healing due to its advantages of safety, simple, low-cost. But some problems still remain to be studied and solved.CONCLUSION: PRP includes many sorts of growth factors and has been proved to be beneficial to the maturation of both bone tissue and soft tissues. PRP is autologous and can be produced easily and safely from autologous blood, without the concerns of transmissions and immunological rejection of various diseases.

Objective To explore the protective effects of polysaccharide from Panax japonicus on free fatty acid in different parts of hepatic cell injury. Methods Polysaccharide of Panax japonicus was prepared through different concentrations of ethanol precipitation and was named as 30%polysaccharide component (pc), 60% pc and 90% pc. Palmitic acid (PA) was used to induce a cellular model of steatosis in HepG2 cells in order to screen the intervention viability of polysaccharide of Panax japonicus. MTT method was used to detect cell viability, and Oil Red O staining was used to demonstrate steatosis. Total RNA was extracted to detect the expression level of the relevant genes. Results MTT results showed that the 30% pc significantly increased cell viability compared with the model group;Oil Red O staining showed that the number of intracellular lipid droplets was significantly reduced in the 30% pc compared with the model group;RT-PCR results showed that expressions of the endoplasmic reticulum stress-related gene glucoese-regulated protein, CCAAT enhancer binding protein homologous protein and TNF-αwere significantly lower in the 30% pc compared with the model group, and there was no significant difference compared with normal control group. Conclusion The 30%ethanol precipitation fraction of polysaccharide from Panax japonicus significantly reduced PA-induced steatosis in HepG2 cells. Its mechanism was possibly realized through intervention in endoplasmic reticulum stress-related response.

Objective:To explore the effect and mechanism of AMPK on apoptosis of alveolar epithelial cells induced by endoplasmic reticulum stress in COPD rats.Methods:the rats were divided into three groups:control group,model group,AICAR intervention group,establishment of rat model of chronic obstructive pulmonary disease by smoking smoke inhalation and intratracheal instillation of lipopolysaccharide.The HE staining of rat lung tissue pathological observation,immunohistochemical detection of p-AMPK /AMPK,western blot the expression of Caspase-3,ORP 150,and CHOP.Apoptosis were detected by TUNEL method.Results:the HE staining showed that the model group of pulmonary bullae formation,inflammatory cell infiltration,inflammatory ceils in AICAR group was lower than that of model group.Compared with the normal control group,immunohistochemistry and Western blot showed that p-AMPK/AMPK and ORP150 protein expression decreased in the model group,the difference was statistically significant (P＜0.05),and AICAR in the intervention group p-AMPK/AMPK and ORP150 protein expression were significantly increased compared with the model group,the difference was statistically significant (P＜0.05).Endoplasmic reticulum stress related apoptosis The expression of CHOP and caspase-3 apoptosis index increased significantly in the model group,there was significant difference compared with normal group (P＜0.05),while in group AICAR,apoptosis index down significantly compared with the model group.Conclusion:AMPK can protect alveolar epithelial cells from cigarette smoke induced endoplasmic reticulum stress and apoptosis,it was possible to achieve its protective effect the increase of ORP150.