Objective To investigate maternal zinc metabolism and the changes of zinc-related factors as metallothionein-1 (MT1) and zinc transporter-1 (ZnT1) in certain types of congenital heart diseases (CHD).Methods Fifteen infants with interventricular septal defect,12 infants with atrial septal defect and 7 infants with tetralogy of Fallot,together with their mothers were enrolled,and normal infants and their mothers were enrolled by a ratio of 1 ∶ 1 with the above three types of CHD diseases.General conditions of the mothers,along with their diets and zinc-containing drug supplementation during the pregnancy,were surveyed.Maternal blood zinc levels and serum alkaline phosphatase activities at gestation week 32 and delivery or induced abortion,and the protein and mRNA expressions of MT1 and ZnT1 in maternal serum and placental tissue at delivery or induced abortion were assayed.Results The general conditions were comparable between the CHD group and control group.The ratio of the mothers taking more zinc-rich food was significantly lower in the CHD group than in the control group.Circulating zinc levels in interventricular septal defect (73.55±5.79 μmol/L),atrial septal defect (72.66±5.82 μmol/L) and tetralogy of Fallot (68.72±6.72 μmol/L) groups were significantly lower than those in the control groups (82.77± 7.88,84.58 ± 7.55 and 85.66 ± 7.30 μmol/L) at delivery (P all ＜ 0.05).Similar change patterns were seen for serum alkaline phosphatase activities.The relative quantities of serum MT1 and ZnT1 proteins in interventricular septal defect (73.22±36.54 and 68.55± 27.82),atrial septal defect (64.29± 38.26 and 74.55 ± 29.67) and tetralogy of Fallot (67.88± 30.50 and 70.13±29.65) groups were significantly lower than those in their corresponding control groups (166.31±67.43and 97.67±30.22,182.56±71.40 and 111.65±32.70,and 173.81±62.36 and 108.27±28.52,P＜0.01 or P＜0.05).The relative quantities of placental MT1 and ZnT1 proteins and mRNA expressions in interventricular septal defect (protein quantities 0.438±0.096 and 0.384±0.061,mRNA expressions 1.23±0.82 and 0.96±0.39),atrial septal defect (0.427±0.093 and 0.377±0.059,1.17±0.70 and 0.85±0.40) and tetralogy of Fallot (0.414±0.111 and 0.336±0.066,1.31±0.97 and 0.90±0.38) groups were significantly lower than those in their corresponding control groups (protein quantities 0.565±0.083 and 0.541±0.090,mRNA expressions 2.78± 1.06 and 1.67±0.33;protein quantities 0.622±0.136 and 0.493±0.079,mRNA expressions 2.85±0.89 and 1.72±0.38;protein quantities 0.637±0.125 and 0.521±0.089,mRNA expressions 3.21 ± 0.99 and 1.61±0.29;P＜0.01 or P＜0.05).Conclusion Mothers with their fetus of certain types of CHD are found zinc deficiency,and down-regulation of MT1 and ZnT1 expressions in the serum and placenta may involve in the pathogenesis of CHD when maternal zinc deficiency.

目的 分析药物流产后患者发生产后出血原因与其卵巢功能状态之间的相关性.方法 选择2015年6月-2017年12月在我院门诊行自愿药物流产的孕周≤7周且B超证实为宫内妊娠者87例进行研究,其中48例通过药流排出孕囊后出血≥10d(观察组),39例出血＜10d(对照组).观察并比较患者的子宫和双侧卵巢超声图像,比较其血清雌二醇(E2)和孕酮(P)水平,分析临床特点和出血原因.结果 观察组中33例(68.75％)宫腔内有残留,其中13例卵巢内液性暗区直径为11～30 cm,其余20例患者一侧卵巢有小滤泡回声,另一侧卵巢大小正常,观察组中另外15例患者除双侧卵巢有小滤泡回声外,子宫超声图像均正常,对照组子宫卵巢超声图像无异常.观察组中宫腔内有残留且B超探查卵巢液性暗区直径11～30 cm患者的血清E2和P均高于无残留者及对照组(P＜0.05),而无残留者的血清E2和P则低于对照组(P＜0.05).结论 药物流产后卵巢功能处于异常状态可能与子宫出血的发生密切相关.

Objective To investigate the effects of maternal exposure to ambient fine particles (PM2.5) in Fuzhou during pregnancy on immune responses to ovalbumin (OVA) in neonatal rats and the possible mechanisms.Methods Pregnant Sprague-Dawley rats were randomly assigned into four groups (ten in each):filtered air (FA) plus normal saline (NS),airborne PM2.5 plus NS (PM2.5-NS),FA plus OVA (FA-OVA) and PM2.5 plus OVA (PM2.5-OVA) groups.Pregnant dams in the PM2.5 exposure groups were placed in a PM2.5 exposure chamber in which the PM2.5 concentration was equal to the ambient air from the beginning of gestation till delivery,whereas the other dams inhaling air without particulate matters were put into a clean chamber.OVA sensitization was conducted through intraperitoneal injection of OVA at 50 μ g per dam at 4 and 9 days of gestation,followed by inhalation of atomized 1％ OVA for 30 min at 18,19 and 20 days of gestation.Dams without OVA sensitization were given NS in the same way.Levels of interleukin (IL)-4,IL-5 and interferon-γ (IFN-γ) in neonatal rats' plasma were measured by enzyme-linked immunosorbent assay just after birth.Protein levels of transcription factors GATA-3 and T-bet in lung were analyzed by Western-blotting.Changes in microRNA(miR)-146a and miR-146b in spleen were detected by real-time polymerase chain reaction.Histological changes in lung were observed under light microscope.One-way analysis of variance and LSD test were used as statistical methods.Results (1) IL-4 level in plasma was significantly increased in PM2.5-NS [(18.56±7.04) ng/L],FA-OVA [(34.04±7.06) ng/L] and PM2.5-OVA groups [(45.67±8.18) ng/L] as compared with that in FA-NS group [(10.51 ±2.88) ng/L],and the level of IL-4 in PM2.5-OVA group was higher than that in PM2.5-NS and FA-OVA groups (F=54.667,P＜0.001).Significantly increased IL-5 level in plasma was found in FA-OVA and PM2.5-OVA groups as compared with that in FA-NS group (F=6.253,P=0.023).Among the four groups,FA-OVA group showed significantly increased IFN-γ level in plasma (F=28.604,P＜0.001).(2) GATA-3 level in lung tissues was significantly increased in PM2.5-NS (31.09 + 3.54),FA-OVA (35.24± 5.00) and PM2.5-OVA groups (47.81 ±3.63) as compared with that in FA-NS group (24.19±3.12),and higher in PM2.5-OVA group than in PM2.5-NS and FA-OVA groups (F=96.581,P＜0.001).T-bet level was significantly lower in FA-OVA and PM2.5-OVA groups than in FA-NS group.Moreover,PM2.5-OVA group showed decreased T-bet level as compared with that in PM2.5-NS and FA-OVA groups (F=30.852,P＜0.001).(3) Expression of miR-146a in spleen was significantly enhanced in PM2.5-NS (1.72±0.27),FA-OVA (1.56±0.37) and PM2.5-OVA groups (3.06± 0.52) than in FA-NS group (1.05 ±0.25).Moreover,PM2.5-OVA group showed enhanced expression of miR-146a as compared with that in PM2.5-NS and FA-OVA groups (F=42.276,P＜0.001).Changes in the expressions of miR-146b were similar to those in miR-146a (F=28.776,P＜0.001).(4) Stenosis or disappearance of alveolar spaces,accompanied with infiltration of inflammatory cells in interstitial substance and congestion in alveolar septum,was seen in FA-OVA and PM2.5-OVA groups and conditions in the latter group were more severe.Conclusions Intrauterine exposure to ambient PM2.5 negatively affects fetal lung development and immunological function in rats,especially when the dams are sensitized with OVA during pregnancy.

Objective To investigate the clinical analysis of 165 cases of uterine sarcoma. Methods The main research ob-ject for the period in June 2000,to June 2014 165 cases of uterine sarcoma patients in our hospital were chosen. Diagnostic analysis results. Results 1 cases in 165 cases of uterine sarcoma: in 165 cases of uterine sarcoma: cancer sarcoma, leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma of the 70 cases, 56 cases, 35 cases, 4 cases; 2 kinds of I pathological stage with a total of 101 cases, a total of 44 cases of II period, III period for a total of 20 cases of.3. patients according to the pathological stage of surgery were divided into grade hysterectomy total hysterectomy, pelvic lymphadenec-tomy, hysterectomy with pelvic lymphadenectomy and chemotherapy, hysterectomy with pelvic lymph node dissection several chemotherapy and radiotherapy treatment effect of different surgical methods, there are differences (P< 0.05). Conclusion In 165 cases Uterine sarcoma patients with carcinosarcoma is in the majority, followed by leiomyosarcoma. Stage by stage I patients mostly, the vagina is bloody rule is uterine sarcoma were the main clinical symptoms. Patients with pathological types, take corresponding treatment, can improve the prognosis.

目的:观察宫腔粘连(IUA)分解术后宫腔内放入玻璃酸钠联合大剂量雌激素口服预防再粘连的效果.方法:宫腔镜确诊为IUA患者272例,分为A组和B组,A组(n=103)行宫腔镜下IUA分离术及宫腔内节育器(IUD)放置术,术后口服大剂量雌激素及孕激素人工周期3个月;B组(n=169)在A组相同治疗的基础上加宫腔内留置玻璃酸钠;比较A组和B组的疗效.结果:中度粘连患者术后粘连再发率B组显著低于A组(P＜0.05);A、B组的治疗有效率分别为:轻度粘连100％、100％;中度粘连83.3％、94.6％;重度粘连68.2％、83.9％(P均＞0.05);轻、中度IUA的治愈率B组显著高于A组(P＜0.05).结论:IUA分解术后宫腔内留置玻璃酸钠联合大剂量雌激素口服可提高预防再粘连的效果,特别对轻、中度IUA效果显著.

<正>月经紊乱是妇女的常见病,除手术治疗外,不论何种药物(如避孕药、高效孕激素、雄激素,以及促性腺激素释放激素激动剂GNRH-a)都未必有效,长期使用这些药物均有不同程度的不良反应,且停药后又面临着复发的问题。笔者用左炔诺孕酮

医院药师是提供药品服务的直接参与者和指导者.无论是传统的医院药学,还是现代的药学监护(临床药学、血药浓度监测、药品不良反应监测、药学咨询等),单纯的收方、发药、供应已不再是医院药师工作的全部,开展药学监护,提供优质、高效的药学服务,制定合理用药方案,指导医师、护士、患者用药等已是医院药师的重要职责.

目的 探讨初孕妇(孕28～36周)引产时息隐配伍米索前列醇方法 不同,引产效果及副反应观察.方法 将孕28～36周健康初孕妇176例,随机分为A组90例,息隐50mg口服q12h×2次;B组86例,息隐75mg顿服,末次眼药时予米索前列醇100μg置阴道后窟窿,间隔6小时,最多应用4次.结果 A组成功率98.8%,B组为90.7%,差异显著.A组以规律宫缩到胎儿娩出时间短于B组,产程中需用催产素加强宫缩的例数少于B组.两组副反应相近.结论 息隐配伍米索前列醇减量对晚孕引产有效,但配伍方法 不同,效果不同.另孕妇对药物的敏感性存在个体差异.

1999年通过对787名初产妇会阴左侧切口采用三种不同方式缝合，临床观察其愈合情况如下。 1 资料与方法 1999年总产妇数1530人，其中有会阴左侧切初产妇为787人，全部入选。 1.1 左侧切口缝合三种方式：Ⅰ组：阴道粘膜层，皮下组织均用0号铬制羊肠线间断缝合，皮肤层4号丝线间断缝合，此种方式也为传统缝合方式。Ⅱ组：阴道粘膜层，皮下组织均用00号华利康可吸收线间断缝合，皮肤也用此线行皮内缝合。Ⅲ组：阴道粘膜层用可吸收线间断缝合，皮下组织和皮肤合用4号丝线间断“8”字缝合。 1.2 各种年龄组成：Ⅰ组26±0．38岁，Ⅱ组26±0．43岁，Ⅲ组26±0．31岁。 1.3 各组孕妇组成情况：见表1。