ABSTRACT
Pregnancy after valve replacement for rheumatic heart disease is a high-risk pregnancy.There are risks of valve thrombosis,anticoagulation-related complications, prosthetic valve dysfunction and prosthetic valve endocarditis.Comprehensive preconception evaluation and strict management should be carried out in order to reduce maternal and neonatal complications.
ABSTRACT
<p><b>BACKGROUND</b>Adiponectin is an adipokine with insulin-sensitising and anti-atherogenic properties. The aim of this study was to investigate whether low adiponectin levels predict the impairment of endothelial function in newly diagnosed type 2 diabetic patients in an 8-year prospective study.</p><p><b>METHODS</b>In the prospective study, we enrolled 133 newly diagnosed type 2 diabetic patients without subclinical atherosclerosis and gave them intensive therapy; the mean treatment period was 8 years. Intensive treatment was a stepwise implementation of behavior modification and pharmacological therapy targeting hyperglycaemia, hypertension, dyslipidaemia and obesity. We measured baseline circulating adiponectin with an enzyme-linked immunosorbent assay, endothelium-dependent and -independent vasodilation by high-resolution vascular ultrasound. At year 8, 102 patients were reexamined for endothelium-dependent and -independent vasodilation.</p><p><b>RESULTS</b>Sex-adjusted adiponectin level was positively correlated with endothelium-independent vasodilation both at baseline (r = 0.150, P = 0.043) and at year 8 (r = 0.339, P = 0.001), whereas no association was found between adiponectin and endothelium-dependent vasodilation. In a stepwise multivariate linear regression model, adiponectin was an independent predictor for impaired endothelium-independent vasodilation at year 8 (P = 0.001).</p><p><b>CONCLUSIONS</b>Plasma adiponectin concentration was associated with endothelium-independent vasodilation and hypoadiponectinemia predicted the impairment of endothelium-independent vasodilation in newly diagnosed type 2 diabetic patients under multifactorial intervention. These data support the causative link of impairment of endothelium-independent vasodilation with hypoadiponectinemia.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Adiponectin , Blood , Diabetes Mellitus, Type 2 , Blood , Endothelium, Vascular , Physiology , Prospective Studies , Vasodilation , PhysiologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the value of ultrasonic monitoring in induced abortion during the first trimester.</p><p><b>METHODS</b>Totally 110 healthy women with a singleton pregnancy between 9 and 11 gestational weeks were enrolled. All the procedures of induced abortion were performed routinely. Ultrasonography was performed when the procedure of induced abortion was completed. Patients with normal ultrasonographic results were assigned in the control group, while patients with abnormal ultrasonographic findings were enrolled in the study group,in which these patients underwent further operations until the ultrasonography showed clear endomembrane line. All the recurretaged tissue in the study group were sent for pathological examinations.</p><p><b>RESULTS</b>Of these 110 patients, 28 (25.5%) entered study group and 82 (74.5%) entered control group. In the study group, trophoblastic cell or chorion was found in the recurretaged tissue in 11 patients (39.3%), in which 3 had trophoblastic cell embedded in smooth muscular tissue, 6 had pathologic deciduas, and 11 had pathologic secretory endometria. In this control group,1 patient (0.9%) had retained products of conception. The operation duration [(20.6∓2.1) min vs.(11.5∓3.5) min, P0.05].</p><p><b>CONCLUSIONS</b>Ultrasonic monitoring in induced abortion during the first trimester can decrease the incidence of retained products of conception and will not induce endometrial damage. It is especially useful for women whose fetuses were at older gestational ages.</p>
Subject(s)
Adult , Female , Humans , Pregnancy , Abortion, Induced , Methods , Monitoring, Intraoperative , Methods , Pregnancy Trimester, First , UltrasonographyABSTRACT
Objective To analyse the health system responsiveness of Huzhou of Zhejiang Province. Methods Performance evaluation method proposed by WHO was employed for the study of responsiveness. The local residents of Huzhou of Zhejiang Province in 2007 were investigated with multilevel cluster stratified sampling. Data were obtained by household survey and involved items such as dignity,independence,privacy,communication,timely attention,equipment,social support and selection of medical staff,and were subjected to empirical analysis. Results Household survey was conducted in 1353 residents,among whom 28.16% lived in town and 71.84% lived in countryside. The index of health system responsiveness of Huzhou was 7.96,slightly higher than that of Zhejiang Province (7.71). The responsiveness was significantly higher for countryside than that for town in independence,communication and timely attention (P