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Objective To investigate the relationship between CD4+CD28na cells,oxidative stress markers malondialdehyde(MDA) and superoxide dismutase(SOD) and the pathogenesis of polycystic ovary syndrome(PCOS).Methods Thirty-two patients with PCOS(PCOS group) and 28 healthy women(control group) were selected.Six ml of peripheral venous blood were taken from each person,3 ml of which were separated and serum was collected.Sex hormone level,C-reactive protein (CRP),SOD and MDA were detected.Peripheral blood mononuclear cells (PBMCs) were isolated from the other 3 ml blood by centrifugation,and CD4+CD28null T cell subsets were detected by flow cytometry.The characteristics of each detected index of PCOS patients and healthy controls were compared.Results The proportion of CD4+CD28null T cells in the peripheral blood of the PCOS group was significantly higher than that of the control group (P＜0.05).The serum CRP and MDA in PCOS group were both significantly higher than that in the control group,and SOD was significantly lower than the control group(P＜0.05).Correlation analysis showed that the expression of CD4+CD28null T cells in the PCOS group was positively correlated with CRP(P＜0.05) and MDA(P＜0.05) and negatively correlated with SOD (P＜0.05).Conclusions Our study shows a disorder of immunoregulatory mechanism represented by abnormal increase of CD4+CD28null T cell expression and an imbalance of oxidative stress in patients with PCOS.The further study of relationship between these two pathophysiological patterns and PCOS may help to elucidate its pathogenesis.
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Objective To observe the changes of shock index (SI) and diastolic blood pressure (DBP) in postpartum hemorrhage patients, and the explore their relationship with postpartum hemorrhage and the clinical significance of early warning of hemorrhage risk. Methods 402 patients with postpartum hemorrhage (within 24 hours after delivery, the amount of bleeding in vaginal delivery≥500 mL, and the amount of bleeding in caesarean delivery≥1 000 mL) admitted to the obstetrics ward of Affiliated Hospital of Hangzhou Normal University from January 2014 to December 2017 were selected as the objective group and 416 without complications during delivery were selected as the control group in the same hospital at the same period. Clinical data in the two groups before and after childbirth was collected, including age, pregnancy week, 24-hour blood loss, and hemoglobin (Hb), whole blood cell parameters, heart rate (HR), systolic blood pressure (SBP), DBP, SI, blood urea nitrogen (BUN), serum creatinine (SCr) within 24 hours before and after delivery, and postpartum 24 hours and prenatal DBP difference (ΔDBP). The differences of indicators were compared between the two groups. Pearson method was used to analyze the correlation between the postpartum DBP and SI in the objective group. Ordinal regression model was used to analyze the early warning risk factors of each index to postpartum hemorrhage. Results Compared with the control group, older age (years: 29.29±5.01 vs. 28.05±4.46), more pregnancies (times: 2.68±1.42 vs. 2.33±1.28), shorter gestation weeks (weeks: 38.33±3.57 vs. 39.05±1.40), more 24-hour blood loss (mL: 726.57±467.66 vs. 244.49±50.25) in the objective group were significant differences (all P﹤0.01). Postpartum hemorrhage patients were successfully hemostatic, no maternal and perinatal death was found in the two groups. Compared with the control group, DBP was significantly decreased at 24 hours after delivery in the objective group [mmHg (1 mmHg = 0.133 kPa): 71.19±12.55 vs. 75.68±8.96, P < 0.05], and ΔDBP was significantly increased (mmHg: 5.39±3.93 vs. 0.67±0.33, P < 0.01). In addition, compared with the control group, SI and HR were significantly increased in the objective group [SI:0.80±0.15 vs. 0.72±0.11, HR (bpm): 91.56±13.37 vs. 82.96±11.76, both P < 0.05], Hb, red blood cell count (RBC), platelet count (PLT) and SBP were significantly decreased [Hb (g/L): 91.30±13.41 vs. 112.30±13.41, RBC (×1012/L): 3.74±0.38 vs. 4.59±0.45, PLT (×109/L): 173.02±59.08 vs. 182.09±54.76, SBP (mmHg):115.13±9.27 vs. 117.94±11.66, all P﹤0.05]. Correlation analysis showed that postpartum DBP was negatively correlated with SI, 24-hour blood loss, ΔDBP, BUN and SCr (r value was -0.419, -0.268, -0.490, -0.108, -0.163, respectively, all P < 0.05), and positively correlated with SBP, Hb and RBC (r value was 0.739, 0.125, 0.096, respectively, all P < 0.05). It was shown by Ordinal regression analysis that the risk of postpartum hemorrhage was significantly increased when ΔDBP≥9.32 mmHg [relative risk (RR) = 2.64, 95% confidence interval (95%CI) =1.94-3.34, P = 0.000], SI≥0.95 (RR = 1.78, 95%CI = 1.01-2.55, P = 0.000), DBP≤59.64 mmHg (RR = 0.86, 95%CI = 0.31-1.41, P = 0.000), SBP≤105.86 mmHg (RR = 0.63, 95%CI = 0.18-1.07, P = 0.000), Hb≤77.89 g/L (RR = 1.68, 95%CI = 0.99-2.38, P = 0.000), and ΔDBP≥9.32 mmHg was the most effective early warning effect. Conclusions Combined with clinical manifestations of patients with postpartum hemorrhage, SI and DBP can be used as an important reference indicator for the observation of postpartum hemorrhage conditions. ΔDBP≥9.32 mmHg can be used as the risk factors of the patient with postpartum hemorrhage.
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Ninety six offspring infants (48 males, 48 females) born by hospitalized patients with intrahepatic cholestasis of pregnancy from January 2010 to February 2013 ( study group) and 108 cases of offspring infants (54 males, 54 females) born by hospitalized healthy pregnant woman ( control group) were enrolled in the study. All offspring infants were followed up for 2 years after birth, physical and neuropsychological development parameters were investigated at 1 month, 1 year and 2 years after birth. There were no significant difference in body weight [ ( 11.94 ±0.89 ) vs.( 13.99 ±0.78 ) kg ] , length [(86.2 ±2.0) vs.(87.0 ±3.1) cm], sitting height, [(51.8 ±2.1) vs.(51.8 ±1.9) cm], head circumference[(47.9 ±1.3) vs.(48.1 ±1.1) cm], development of intelligence quotient index[(99.4 ± 12.9) vs.(100.0 ±12.0)] at 2 years after birth between two groups (P>0.05).Two-year follow up reveals that ursodeoxycholic acid and S-adenosine methionine treatment for women with intrahepatic cholestasis of pregnant has no significant adverse effect on the growth and development of their offspring.