Objective:To compare the effect of misoprostol respectively with sublingual administration and rectal administration in the treatment of postpartum hemorrhage. Methods:Totally 72 pregnant women were randomly divided into two groups with 36 cases in each. The sublingual group was given misoprostol 600 μg under the tongue immediately after the front shoulder of baby was delivered, while the rectal group was given misoprostol 600μg into rectum deeply. The amount of blood loss in 2 hours and 24 hours after the de-livery and the adverse reactions were compared between the two groups. Results: The postpartum hemorrhageon in 2 hours and 24 hours of the sublingual group was significantly less than that of the rectal group, and the incidence of postpartum hemorrhage in the sub-lingual group was significantly lower than that of the rectal group, and the difference was statistically significant (P<0. 05). After the treatment, the incidence of adverse reactions between the two groups had no significant difference (P>0. 05). However, the incidence of shiver in the sublingual group was significantly higher than that in the rectal group, and the difference was statistically significant ( P<0. 05). Conclusion:The preventive effect of misoprostol with sublingual administration on postpartum hemorrhage after natural vagi-nal delivery is better than that with rectal administration, which is safe and convenient, and worthy of promoted application in clinics.

Objective To review the clinical features and diagnosis of syphilitic aortic aneurysm .Methods A case of syphilitic aortic aneurysm was reported and the relevant literatures were reviewed .Results The patient showed progressive hoarse and heart murmurs and was diagnosed by computed tomographic angiography of aorta and syphilis serology test .In the era of antibiotics ,syphilitic aortic aneurysm is a very rare and dangerous case with covert onset ,various manifestations and high mortality .Conclusions The prevalence of late cardiovascular syphilis is increasing with the increase of early-onset syphilis and HIV epidemic .Syphilis serologic test should be available for the young patients with aortic aneurysm even though the risk factors of coronary heart disease are not present .Medical and surgical treatments for syphilis should be provided for the patients who are clinically suspected of syphilitic aortic aneurysm .

This study is to prepare the pantoprazole sodium enteric-coated tablet which is compacted by pellets. The enteric-coated pantoprazole sodium pellets were prepared by fluid bed coating technology. The pantoprazole sodium enteric-coated tablets were prepared by direct compression of the enteric-coated pellets and suitable excipients. In vitro dissolution method and scanning electron microscope method were used for the observation of the drug release behavior before and after compression of the pellets. The optimized formulation is: the coating level is 55%, the plasticizer content is 20%, the ratio of Eudragit L30D-55/NE30D is 8 : 2, enteric-coated pellets/excipients (MCC/PPVP/PEG 6000 = 2 : 1 : 1) is 5 : 5, the enteric-coated tablets release in artificial gastric fluid in 2 h is less than 10%, while in artificial intestinal fluid in 1 h is more than 85%. The release behavior of pantoprazole sodium enteric-coated pellets-type tablet is quite well. And it may be used in industrial production.

Objective To analyze 206 cases of pregnant women with multiple organ dysfunction syndrome(MODS)due to different primary diseases and the prognosis.Method A retrospective study was conducted of 206 cases of pregnant women with MODS who were treated during January 2000 to December 2006 in the Third Affiliated Hospital of Guangzhou Medical College,regarding their primary disease and prognosis.Results Fourty-four cases among the 206 pregnant women with MODS died.The main primary causes were postpartum hemorrhage in 63 cases(30.6%),severe preeclampsia or eclampsia 60 cases (29.1%),pregnancy with hepatitis C in 23 case(11.2%),pregnancy with heart disease in 11 cases (5.3%),12 cases of ectopic pregnancy(5.8%).The mortality was mainly because of pregnancy complicated with heart disease(63.6%),ectopic pregnancy(41.7%),pregnancy with hepatitis (22.7%),of postpartum hemorrhage(17.5%)and severe preeclampsia-eclampsia(11.7%).The difference was statistically significant(P

Objective To study the expression of P57kip2 and its clinical significance in hilar bile duct adenocarcinoma.Methods The expressions of P57kip2 in hilar bile duct adenocarcinoma tissues (37 cases) and normal bile duct tissues (32 cases) were determined by immunohistochemical SP methods.The relations between the expression levels of P57kip2 with clinicopathologic parameters were analyzed.Results The positive rate of P57kip2 was 43.2％ (16/37) in bile duct adenocarcinoma,while it was 87.5％ (28/32) in normal duct tissues (P ＜0.01).The expression level of P57kip2 in adenocarcinoma showed no significant association with gender,age or CA19-9 level (P ＞0.05),but they were significantly related with lymph node metastasis,invasion and degree of differentiation (P ＜ 0.05).Conclusions P57kip2 is associated with the occurrence and development of hilar bile duct adenocarcinoma.It may play an important role in invasion and metastasis of hilar bile duct adenocarcinoma.The P57 protein can be used as an index to diagnose hilar bile duct adenocarcinoma.

Aged ; Amyloidosis ; complications ; diagnosis ; Diagnostic Errors ; Dyspnea ; etiology ; Edema ; etiology ; Female ; Humans ; Immunoglobulin Light-chain Amyloidosis

Objective To explore the feasibility of the double venipuncture instead of central venous catheter as a temporary vascular access in hemodialysis.Methods The upper arm below the 1/3 was tied a tourniquet,and fistula needle directly punctured the vein in the middle of the elbow.After the success of the puncture,elastic bandage was replaced by a tourniquet,and the ball movement was done by imitating the blood donation member for blood donation at hand gripping a ball or elements as the artery blood lead.Another elbow vein or lower limb saphenous vein was punctured.Thirty patients using double venipuncture dialysis or central venous catheter dialysis 2 weeks or more were randomly selected into each group,and biochemical and renal function was measured before dialysis.Results All of 1 282 patients who were newly into the blood dialysis,mature arteriovenous fistula was in 8 patients (0.6％,8/1 282),deep venipuncture to insert the central venous catheter was in 542 patients(42.3％,542/1 282),using the double venipuncture was in 732 patients (57.1％,732/1 282).The flow of blood was 180-200 ml/min,the avalible time was 1-2 months.The serum creatinine,blood urea nitrogen,calcium,phosphorus and carbon dioxide combining power had no significant difference between two groups (P ＞ 0.05).Conclusions The majority of patients with double venipuncture blood flow can satisfy the need of dialysis.Because the operation is simple,no recycling and may reduce the deep venipuncture,it is an ideal temporary vascular access.

Meisoindigo is an indigo natural derivative commonly used in anti-cancer therapy. In the clinical application, it was also found to have good therapeutic effect on psoriasis. In order to further understand its mechanism of action, human normal keratinocyte cell line HaCaT and RAW 264.7 were used to identify if meisoindigo could affect the inflammatory factors such as NO and other important cytokines which were highly involved in psoriasis. Our results indicated that meisoindigo decreased the production of NO in LPS-stimulated RAW 264.7 cells and reduced the expression of cytokines in LPS-stimulated HaCaT cells. And TLR4-TAK-NF-kappaB was a possible pathway mainly involved in the attenuation of iNOS and pro-inflammatory cytokine production by meisoindigo, which may take part in the therapeutic effect of meisoindigo on psoriasis.

Objective To investigate the effect of ischemia/reperfusion(I/R) on tumor metastasis in a experimental mouse model of hematogenous metastasis after I/R; we also quantitated expression of matrix metalloproteinases-9 (MMP-9) during I/R.Methods An experimental mouse model of metastasis after partial hepatic I/R was designed to determine the effects of I/R on tumor metastasis to liver.Tumor loads were valued 7 days after operation.In addition,tissue analysis for alanine transaminase,aspartate transaminase (AST) and matrix metalloproteinases and 8 h reperfusion were performed.Results After 2 h hepatic reperfusion,ALT and AST in I 45 min group were higher than the sham group and I 30 min group (P ＜0.05).ALT and AST in the sham group were both a little higher than the normal.ALT and AST in the I 45 min group and I 30 min group at 8 h were both higher than those at 2 h reperfusion(P ＜0.05).The tumor load (valued by Hepatic replacement area) and the expression of MMP-9 in ischemic lobe in I 45 min group were greater than that after 30 min group and sham group.(P =0.013,P =0.007).There was no statistical difference on tumor load between the right lobe of sham operated mice and the right lobe (non-ischemic lobe) of mice subjected to I/R(P =0.089).Mouse survival were compared among the groups.Mice in Sham group lived longer than I 30 min group (P =0.041).And there were no statistical significance between I 45 min group and I 30 min group (P =0.055).MMP-9 expression in I 45 min group was higher than I 30 min group(P ＜ 0.001).Conclusion Hepatic I/R promotes liver hematogenic metastasis of hepatocellular carcinoma in mice through induction of MMP-9 expression.

Objective To investigate the reliability of a novel rating scale, unified multiple system atrophy rating scale, section Ⅰ(UMSARS-Ⅰ) in the evaluation of illness severity in patients with multiple system atrophy (MSA). Methods A retrospective analysis and a prospective follow-up study were conducted by using UMSARS-Ⅰ in 46 patients with MSA, and the Schwab and England scale was employed and illness severity was graded. The reliability, validity and sensitivity to change of UMSARS-Ⅰ in evaluating the illness severity of MSA were estimated. Results UMSARS-Ⅰ enjoyed high internal consistency (standard Crohnbach's ?=0.88) and sound content, criterion-related, construct and discriminant validity in the evaluation of illness severity of MSA, and a moderate sensiti-vity to change was found(effect size=0.61). Conclusion UMSARS-Ⅰ is a reliable and multidimensional semi-quantitative scale in the measurement of severity and progression of impairment in MSA.