Objective　To investigate whether matrix metalloproteinase-9 (MMP-9) was synthesized in pregnant cervix during parturition and its source and distribution. Methods　Cervical species (n=10, each weighing about 0.3 g) were taken from pregnant women immediately after delivery. Other cervical species (n=7) were served as negative control from those non-pregnant women but undergoing uterotomy due to other benign diseases. Immunohistochemical method (ABC) was carried out to detect the expression of MMP-9, with a monoclonal antibody against MMP-9. Results　Positive staining of MMP-9 was found in the cytoplasm of polymorphonuclear leukocytes (PMN) that had infiltrated into cervix or located in blood vessels of cervix. Scattered light positive staining were found in some interstitial cells of the cervix. No other cells including fibrocytes and lymphocytes were positive to MMP-9. No positive staining was found in control tissues. Conclusion　There are strong expressions of MMP-9 in pregnant cervix in term labor, derived mainly from infiltrated PMN. MMP-9 may be an important regulator in the process of cervical ripening.

Objective To investigate the change of vascular endothelial growth factor (VEGF) in placenta for patients with intrahepatic cholestasis of pregnancy in order to search the pathogenesis of intrahepatic cholestasis of pregnancy(ICP).Methods 33 ICP patients and 30 normal advanced pregnancy (NLP) were studied.The distribution of VEGF expression and blood capillaries density in placenta were detected respectively by s-ABC immunohistochemistry,and by western blot method.Results The distribution of VEGF in placenta was similar those of ICP and NLP ,but level of expression of VEGF in placenta was significantly lower in ICP than that of NLP (P

Objective To investigate the relationship of vascular endothelial growth factor (VEGF) with bile acid in intrahepatic cholestasis of pregnancy patients (ICP). Methods Thirty three ICP patients and 30 normal pregnant women in late pregnancy were studied, maternal serum VEGF concentrations were examined by enzymelinked immunoadsorbent assay (ELISA). Capillaries density in placenta are detected by s ABC immunohistochemistry, radio immunity method is used to assay the maternal serum glycocholic acid. Results Serum VEGF in ICP (2 072? 17) ng/L has negative correlation with glycocholic acid (47 9?14 2) ng/L, however, positive correlation with capillaries density in placenta (68?5)/HP; The serum VEGF in normal pregnant woman (2 256?30) ng/L does not have relationship to glycocholic acid (1 6?0 7) ng/L but it has positive correlation with capillaries density in placenta (74?7)/HP.Conclusion Cytotoxicity of high concentration bile acids impairs vascular endothelial cells resulting in lower excretion of VEGF in vascular endothelial cells of ICP, which lead to placental blood capillaries dysplasia and lower permeability, it may be one of reasons of fetal distress and fetal death in uteri in ICP.

Objective To investigate if diastolic function could be improved by cardiac sympathetic nerve blockade in patients with dilated cardiomyopathy (DCM). Methods Sixty consecutive cases of DCM were randomed into therapeutic group and control group. Patients in therapeutic group were administered thoracic epidural blockade (TEB) (T 1-5 ) with 0.5 % lidocaine intermittent injection every two hours for four weeks, in addition to some routine medicine, while patients in control group were only administered routine treatment. Then the parameters of left ventricular diastolic function were evaluated with Doppler echocardiography before and after four weeks. Results ①All the patients in TEB group felt better within five minutes after injection of lidocaine within local epidural cavity.Their symptoms were relieved more rapidly than those of the drug therapy alone. Some patients with NYHA class Ⅳ could lie down supine in a short time. Exercise tolerance increased in patients with NYHA class Ⅱ to Ⅲ. But symptoms and signs of patients in control group were relieved very slowly, some patients even got worsen. ② Thirteen of thirty in therapeutic group got improvement on diastolic function after treatment. One of thirty in this group deteriorated. In detail, six of fifteen patients with demonstrated improvement of left ventricular diastolic filling changed from having a restrictive filling pattern to having a pseudonormal left ventricular filling pattern. Four of nine patients with a pseudonormal filling pattern changed to have a delayed filling pattern.Three of six patients, left ventricular filling pattern moved from a pseudonormal left ventricular filling pattern to a normal filling pattern. Only one patient acquired a restrictive filling pattern from a pseudonormal filling pattern. In contrast, in control group one of thirty got improvement on diastolic function after treatment. Nine of thirty in this group deteriorated. Individual changes of left ventricular filling pattern showed that only one patient improved from a delayed filling pattern to normal filling pattern, whereas seven patients had a restrictive left ventricular filling pattern developed from a pseudonormal filling pattern and another two patients achieved a pseudonormal filling pattern from delayed filling pattern. Conclusions Diastolic function in patients with DCM was improved significantly by cardiac sympathetic nerve blockade. The approach has beneficial effects on the patients of DCM.

Objective To establish the quality standard of Catharsis Tea. Methods Rhei Radix et Rhizoma, Scutellariae Radix and Aurantii Fructus were identified by thin-layer chromatography (TLC). HPLC method was established for the determination of emodin and rhein, performed on SunFire C18 column (4.6 mm×250 mm, 5 μm), with methanol-0.1%H3PO4 (85∶15) as the mobile phase at the flow rate of 1.0 mL/min, column temperature at 30 ℃, and detection wavelength of 254 nm. Results The TLC was exclusive. Within the range of 0.448-1.344 μg, emodin presented a fine linear relationship, r =0.999 7. Within the range of 0.011-0.077 μg, rhein presented a fine linear relationship, r=0.999 8. The recovery of rhein and emodin was 98.52% and 97.53% with RSD of 1.02% and 1.15% (n=6) respectively.Conclusion The methods are reliable, accurate, reproducible, and can be used for the quality control of Catharsis Tea.

Objective To determine the prevalence and prognostic implication of hypocalcemia in the set-ring of acute myocardial infarction. Method The study consisted of 1274 consecutive patients presenting with a-cute myocardial infarction. Plasma calcium concentrations were obtained on the 1st day, 2nd day, 3rd day after admission. According to the plasma calcium concentrations, 1274 patients with AMI were designed into four groups:group A (Ca2+≥2.20 mmol/L),gronp B (2.00～2.19 mmol/L), group C (1.90～1.99 mmol/L),group D (Ca2<1.9 mmol/L). Echocardiographic examination was performed on day 2 or 3 of hospitalization.Results There were 606 patients (47.6%) having hypocalcemia, defined as a plasma calcium level <2.2mmol/L. Among them, there were 476 patients(37.4%) in group B(2.00～2.19 mmol/L), 73 patients(5.7 %)in group C (1.90～1.99 hanoi/L) and 45 patients(3.5%)in group D(Ca2+< 1.90 retooL/L). The mortality of group A was 2.5 %, on the contrary, the mortality of the other groups was 7.8 %, 20.5 %, 17.8 %. The difference was significant. In multivariate logistic regression analysis, hypocalcemia was independently associated with 30-day mortality. Conclusions Hypocalcemia in patients with acute myocardial infarction is an independent predictor of 30-day mortality.

Objective To study the role of Gelatinase and interleukin 8 (IL 8) in premature rupture of membrane (PROM). Methods Sixty pregnant women were divided into two groups. In the observation group, were the pregnant women ( n=30 ) complicated with PROM. The women whose membranes ruptured either normally or manually in cesarean delivery were in the control group. Activities of total gelatinases in amniotic fluid were calculated after the experiment of enzyme linked immunosorbent assay (ELISA) with actin labeled gelatin. The electrophoresis of gelatinase was taken according to reference. IL 8 was determined by sandwich ELISA. Results (1) The activity of total gelatinases of amniotic fluid in observation and control groups during the period before labor, latent stage and active stage were (85?10)?g/L?12 h, (91?7)?g/L?12 h, (104?23)?g/L?12 h, (49?15)?g/L?12 h, (58?15)?g/L?12 h and (102?29)?g/L?12 h respectively,the activity of total gelatinases in active stage was significantly higher than that before labor ( P

Objective To explore the mechanism of effects of cardiac sympathetic anesthesia on left ventricular ejection fraction(LVEF) and left cardiac cavity size of patients with dilated cardiomyopathy.Method 121 consecutive patients with dilated cardiomyopathy were divided into cardiac sympathetic nerve blockade group(TEA group) and control group(c group).In TEA group,5％ lidocaine was injected into thoracic epidural cavity for about 4 to 8 weeks in addition with routine therapy.In c group,only routine therapy was used.We observe the changes of LVEF and left cardiac cavity size before and after treatment in both groups. Result In TEA group,after anesthesia,LVEF was increased from(31.3± 12.8) to(47.3± 21.3),P<0.001;left ventricular end－ diastolic diameter was reduced from(69.1± 7.1)to (65.1± 8.0),P<0.001;left atrial diameter was decreased from(44.0± 6.2)to(39.4± 7.2),P< 0.001. Conclusion Cardiac sympathetic anesthesia can effectively improve the ejection performance of dilated cardiomyopathy and make the dilated cardiac cavity turn to normal level.

Objective To investigate the echocardiographic features of complete transposition of the great arteries (TGA)in fetuses.Methods Prenatal echocardiographic data of 9 fetuses diagnosed as TGA by autopsy or postnatal echocardiography during January 2010 to January 2017 were retrospectively analyzed.Results All of 9 fetuses showed normal cardiac axis and atrioventricular connection on four-chamber view.Eight of them showed the baby bird's beak sign on left ventricular outflow tract view.On left and right ventricular outflow tracts view,the two great arteries were parallel in 8 fetuses.Totally 6 fetuses showed just 2 vessels on three vessels and tracheal (3VT) view.On aortic arch view,the radian of aortic arch had increased in different degrees in 7 fetuses.There were 4 fetuses with ventricular septal defect observed by both of four-chamber and left ventricular outflow tract views.Conclusion The echocardiographic features of fetuses with TGA are characteristic in left ventricular outflow tract,left and right ventricular outflow tracts,3VT and aortic arch views,including baby bird's beak sign,2 great arteries' parallel relations,only 2 vessels on 3VT view,and increased radian of aortic arch.Of these features,baby bird's beak sign is the most common.

Objective To investigate the effect of early application of aldosterone receptor blockade-spironolactone on cardiac remodeling in patients with acute myocardial infarction.Methods A total of 616 patients were enrolled in this prospective study,who were admitted to the CCU Division of the First Affiliated Hospital of Harbin Medical University from January 2008 to January 2010.Inclusive criteria were as follows:First-onset STEMI according to the diagnostic criteria in ST-segment elevation acutemyocardial infarction diagnosis and treatment guidelines and admitted within 24 hours from onset.Exclusive criteria were as follows:Non-STEMI,only right ventricular infarction and old myocardial infarction; cardiac function Killip Class Ⅳ or hypotensive state; renal dysfunction(serum creatinine ＞ 221 μmol / L); serum potassium ＞5.0 mmol / L; longer than 24 hours from onset and older than 75 years of age.All the patients were randomly divided into a control group of standard therapy and a treatment group of standard therapy combined with spironolactone 20 mg per day.Totally 528 patients were observed completely,including 266 patients in the control group and 262 patients in the treatment group.There was no statistical difference of clinical characteristics between the two groups,including age,gender,past medical history,admission situation,and treatment(P ＞ 0.05).The effect of spironolactone on cardiac remodeling、left ventricular function、renal function and blood levels of potassium were evaluated by detecting echocardiography,serum potassium and serum creatinine at one month and one year follow-up.Results Compared with the control group,the echocardiography indicators such as LVESD,LVEDD,LVEF,LAD-ML and LAD-SI were significantly improved in treatment group at one year(P ＜ 0.05).In treatment group,LVESD,LVEDD,LVPWT,LVEF,LAD-ML and LAD-SI were significantly improved at one year than one month(P ＜ 0.05,and P =0.007 to LVEF),and LVEF was significantly improved at one year than one month in control group(P =0.0277).There were no statistical differences of serum potassium and serum creatinine between the two groups.Conclusions On the basis of conventional treatment,the early combination of low dose spironolactone(20 mg/d)could inhibit cardiac remodeling at late stage and prevent heart failure.