Objective::To investigate the possible regulatory mechanism of corticotropin-releasing hormone (CRH), urocortin (UCN), and Wolfram syndrome 1 (WFS1) in 17α-ethynylestradiol (EE)-induced intrahepatic cholestasis pregnant rats and its ischemia reperfusion (IR) model.Methods::Pregnant rats ( n=60) were randomly divided into four experimental groups by random number table (Control, EE, IR, and EE-IR groups),and were studied on the 17 th, 19 th, and 21 st gestational days (GD) ( n=5 in each group at the indicated time). Growth and development indicators of fetal rats among these four groups were recorded. Enzyme-linked immunosorbent assay was employed to detect CRH, UCN, and WFS1 levels in maternal sera. Western blotting and real-time polymerase chain reaction were used to quantify placental protein and placental mRNA levels of CRH, UCN, and WFS1. Multivariate analysis of variance and least significant difference test were used to establish the group and individual comparisons. Results::A significant difference was found in placenta weight ( F=8.10, P<0.05), fetal rat weight ( F=40.86, P<0.05), fetal rat length ( F=61.61, P<0.05), and fetal rat tail length ( F=55.63, P<0.05) among four groups on the 17 th ,19 th , and 21 st GD.What’s more, the overall differences of maternal serum UCN levels among Control, EE, IR, and EE-IR groups were significant ( F=2.48, P<0.05). Expression of WFS1 mRNA in the EE-IR group was significantly increased and higher than Control (0.46±0.15 vs. 0.24±0.09, P<0.05), EE (0.46±0.15 vs. 0.17±0.04, P>0.05), and IR (0.46±0.15 vs. 0.22±0.15, P>0.05) groups at 19 th GD, indicating that endoplasmic reticulum stress may be activated. However, the expression of CRH (0.42±0.05 vs. 0.58±0.12, P<0.05), UCN (0.43±0.01 vs. 0.47±0.16, P>0.05), and WFS1 (0.57±0.07 vs. 0.74±0.12, P>0.05) protein in the EE-IR group was subsided compared to the IR group at 17 th GD. Conclusion::Fetal rat growth restriction was found in the EE-induced intrahepatic cholestasis model. This study revealed that significant changes in the maternal sera level of UCN , placental level of WFS1 mRNA and placental levels of CRH, UCN, and WFS1 protein in chronic versus acute stress in a rat model of pregnancy. This suggests an impaired compensatory vasodilatory effect mediated by these factors at gene transcription and protein translation levels, following acute hypoxia stress in EE-induced intrahepatic cholestasis in pregnant rats.

Objective::To investigate the possible regulatory mechanism of corticotropin-releasing hormone (CRH), urocortin (UCN), and Wolfram syndrome 1 (WFS1) in 17α-ethynylestradiol (EE)-induced intrahepatic cholestasis pregnant rats and its ischemia reperfusion (IR) model.Methods::Pregnant rats ( n=60) were randomly divided into four experimental groups by random number table (Control, EE, IR, and EE-IR groups),and were studied on the 17 th, 19 th, and 21 st gestational days (GD) ( n=5 in each group at the indicated time). Growth and development indicators of fetal rats among these four groups were recorded. Enzyme-linked immunosorbent assay was employed to detect CRH, UCN, and WFS1 levels in maternal sera. Western blotting and real-time polymerase chain reaction were used to quantify placental protein and placental mRNA levels of CRH, UCN, and WFS1. Multivariate analysis of variance and least significant difference test were used to establish the group and individual comparisons. Results::A significant difference was found in placenta weight ( F=8.10, P<0.05), fetal rat weight ( F=40.86, P<0.05), fetal rat length ( F=61.61, P<0.05), and fetal rat tail length ( F=55.63, P<0.05) among four groups on the 17 th ,19 th , and 21 st GD.What’s more, the overall differences of maternal serum UCN levels among Control, EE, IR, and EE-IR groups were significant ( F=2.48, P<0.05). Expression of WFS1 mRNA in the EE-IR group was significantly increased and higher than Control (0.46±0.15 vs. 0.24±0.09, P<0.05), EE (0.46±0.15 vs. 0.17±0.04, P>0.05), and IR (0.46±0.15 vs. 0.22±0.15, P>0.05) groups at 19 th GD, indicating that endoplasmic reticulum stress may be activated. However, the expression of CRH (0.42±0.05 vs. 0.58±0.12, P<0.05), UCN (0.43±0.01 vs. 0.47±0.16, P>0.05), and WFS1 (0.57±0.07 vs. 0.74±0.12, P>0.05) protein in the EE-IR group was subsided compared to the IR group at 17 th GD. Conclusion::Fetal rat growth restriction was found in the EE-induced intrahepatic cholestasis model. This study revealed that significant changes in the maternal sera level of UCN , placental level of WFS1 mRNA and placental levels of CRH, UCN, and WFS1 protein in chronic versus acute stress in a rat model of pregnancy. This suggests an impaired compensatory vasodilatory effect mediated by these factors at gene transcription and protein translation levels, following acute hypoxia stress in EE-induced intrahepatic cholestasis in pregnant rats.

Objective:To investigate the safety, efficacy and application indication of intra-operative cell salvage (IOCS) in cesarean section.Methods:A total of 1 265 pregnant women who received IOCS blood transfusion during cesarean section in 11 tertiary A hospitals from August 2016 to January 2019 were collected and divided into <1 500 ml group (796 cases) and ≥1 500 ml group (469 cases) according to the amount of blood loss during cesarean section. The general clinical data, ultrasonic imaging data, perinatal and puerperium indicators were analyzed retrospectively. The risk factors of intraoperative blood loss ≥1 500 mL using IOCS transfusion were analyzed by logistic multivariate regression.Results:(1) A total of 848 001 ml of blood was recovered and a total of 418 649 ml of blood was transfused in 1 265 pregnant women who received IOCS transfusions, which was equivalent to 23 258 U red blood cell suspension, greatly saving medical resources. The intraoperative blood loss in <1 500 ml group and ≥1 500 ml group was 800 ml (300-1 453 ml) and 2 335 ml (1 500-20 000 ml), respectively. No amniotic fluid embolism, severe adverse reactions, shock and death occurred in the two groups. (3) Multivariate regression analysis showed that age ≥35 years ( OR=1.5, 95% CI: 1.1-1.9), prenatal hemoglobin level <110 g/L ( OR=1.7, 95% CI: 1.3-2.2), history of uterine surgery ( OR=1.8, 95% CI: 1.3-2.6), placenta previa ( OR=1.9, 95% CI: 1.1-3.1), placenta accreta ( OR=2.6, 95% CI: 1.8-3.9), blood pool in the placenta ( OR=1.6, 95% CI: 1.1-2.3), abnormal posterior placenta muscle wall ( OR=1.8, 95% CI: 1.2-2.6), placenta projecting to the anterior uterine wall ( OR=3.0, 95% CI: 1.3-7.0) were risk factors for blood loss ≥1 500 ml in obstetric transfusion using IOCS technique, with statistical significance (all P<0.05). Conclusion:IOCS is safe and effective in cesarean section, which could save the medical resources and reduces medical expenses, however, it is necessary to strictly master the application indication.

With the international standardization for drugs and clinical trials, China established its management system to supervise the institutions that carry out drug tests and clinical trials. This article presents a systematic research of Beijing Clinical Pharmacological Center, to explore existing problems in clinical trials and propose strategies and measures to cope with these problems, thus facil itate the development of clinical drug trials in Beijing.

BACKGROUNDAn accurate pre-operative tumor staging is the premise for a successful operation, for which a non-invasive evaluation of the nature of lung nodules and the real extent of them is necessary. As the pioneer of functional images, nuclear medicine continues to introduce novel radiopharmaceuticals and new techniques for cancer imaging, including tetrofosmin (TF). The aim of this study is to evaluate the clinical usefulness of 99m Tc-tetrofosmin SPECT ( 99m Tc-TF SPECT) in the diagnosis of lung cancer and mediastinal lymph node involvement.

METHODSThirty-three patients with pulmonary neoplasms took both CT scan and 99m Tc-TF SPECT in one week before their operations or puncture biopsy. Then the sensitivity, specificity and accuracy were acquired according to the pathological outcomings and the results of 99m Tc-TF SPECT and CT were compared in detection of lung cancer and mediastinal lymph node metastasis, respectively.

RESULTSThe sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99m Tc-TF SPECT for lung cancer were 95.7%, 80.0%, 90.9%, 91.7%, 88.9%, and 73.9%, 70.0%, 72.7% , 85.0% , 53.8% by CT, respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99m Tc-TF SPECT for mediastinal lymph node metastasis were 93.3%, 75.0%, 87.0% , 87.5%, 85.7%, while those of CT were 60.0%, 75.0%, 65.2%, 81.8%, 50.0% respectively. The sensitivity of 99m Tc-TF SPECT was significantly higher than that of CT for lung neoplasms (P < 0.05).

CONCLUSIONS99m Tc-TF SPECT is a useful non-invasive presurgical tool to evaluate primary lung cancers and mediastinal lymph node involvement, and it will play a favorable clinical role in diagnosis and staging of lung cancer.