PPARfJ involved in endothelial cell injury induced by high glucose via nitrative stress / 中国药理学通报

Aim To investigate the role of PPARβ and nitrative stress in human umbilical vein endothelial cells(HUVECs)injury induced by high glucose.Methods The cell viability was detected by CCK-8.The cell proliferation was detected by EdU proliferation detection kit.The protein expression level of PPARβ,eNOS,iNOS,and 3-nitrotyrosine was detected by Western blot.The content of peroxynitrite and nitric oxide(NO)was determined by peroxynitrite kit and Griess Reagent,respectively.Results Glucose(30,40,50 mmol·L-1)significantly reduced the cell viability of HUVECs in a dose-dependent manner.Glucose at 30 mmol·L-1(high glucose,HG)significantly reduced the proliferation of HUVECs,down-regulated the expression of PPARβ,eNOS at protein level and NO content,and increased iNOS,3-nitrotyrosine protein expression and peroxynitrite level.The above effects of HG were reversed by PPARβ agonist GW0742(1 μmol·L-1).Both PPARβ antagonist GSK0660(1 μmol·L-1)and NOS inhibitor L-NAME(10 μmol·L-1)blocked the protective effects of GW0742.Conclusion The down-regulation of PPARβ is involved in the injury of HUVECs induced by high glucose,which may be mediated,at least partly,by the stimulation of nitrative stress.

Chemical Components and Mechanism of Qiling Wenshen Formula in Treating Polycystic Ovary Syndrome / 中国实验方剂学杂志

ObjectiveTo systematically analyze the chemical components of QiLing Wenshen （QLWS） formula and explore the key active components and mechanism of the formula in the treatment of polycystic ovary syndrome （PCOS）. MethodThe chemical components of QLWS formula were systematically identified by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF/MSE） combined with comparison with reference substances， literature data， and databases. Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and SwissADME were employed to screen the active components for network pharmacological analysis. SwissTargetPrediction， GeneCards， DisGeNET， and DrugBank were used to obtain the potential components and targets of the formula for the treatment of PCOS. The protein-protein interaction （PPI） network was constructed via STRING database for further screening of the core targets. Gene ontology （GO） annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment of core targets were carried out with DAVID database. Molecular docking was performed in MOE 2019. ResultA total of 90 components of QLWS formula were identified， and 32 active components and 45 core targets for treating PCOS were obtained. GO annotation obtained 429 terms and KEGG pathway enrichment screened out 110 signaling pathways， mainly involving phosphatidylin-ositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway， estrogen signaling pathway， and hypoxia inducible factor-1 （HIF-1） signaling pathway. The molecular docking revealed that key active components in QLWS formula were icariin， salvianolic acid A\B\C， wogonin， magnoflorine， etc.， which may play a role in treating PCOS through regulating mitogen-activated protein kinase 1 （MAPK1）， epidermal growth factor receptor （EGFR）， mitogen-activated protein kinase 3 （MAPK3）， etc. ConclusionThis study preliminarily predicted that several key active components of QLWS formula could treat PCOS via multiple targets and multiple pathways based on UPLC-Q-TOF/MSE and network pharmacology， which could provide ideas and references for the study of pharmacodynamic material basis and mechanism of action of the formula.

Vaginal sling implant misdiagnosed as rectal subepithelial tumor

As cosmetic procedures receive increasing attention from the media, female genital cosmetic surgery (FGCS) has become quite popular in Korea. The safety and efficacy of these surgeries and procedures have yet to be thoroughly documented. We report a case of a 47-year-old woman who underwent a vaginal sling implantation, which resulted in the misdiagnosis of a rectal subepithelial tumor during endoscopic mucosal resection (EMR). This patient suffered an iatrogenic rectal perforation during the EMR, which necessitated an exploratory operation. The sling implant was removed via the vaginal approach, and a primary repair of the vaginal and rectal walls was performed. The patient subsequently showed no sign of complication at her 6-month follow-up. Patients need to be educated about the importance of reporting a history of FGCS prior to undergoing surgical or endoscopic procedures. Also, physicians have to check the medical history of patient thoroughly to avoid misdiagnoses and unnecessary treatment.

The relationship between spontaneous abortion and female workers in the semiconductor industry

BACKGROUND: This study investigated the relationship between job type and the risk for spontaneous abortion to assess the reproductive toxicity of female workers in the semiconductor industry. METHODS: A questionnaire survey was administered to current female workers of two semiconductor manufacturing plants in Korea. We included female workers who became pregnant at least 6 months after the start of their employment with the company. The pregnancy outcomes of 2,242 female workers who experienced 4,037 pregnancies were investigated. Personnel records were used to assign the subjects to one of three groups: fabrication process workers, packaging process workers, and clerical workers. To adjust for within-person correlations between pregnancies, a generalized estimating equation was used. The logistic regression analysis was limited to the first pregnancy after joining the company to satisfy the assumption of independence among pregnancies. Moreover, we stratified the analysis by time period (pregnancy in the years prior to 2008 vs. after 2009) to reflect differences in occupational exposure based on semiconductor production periods. RESULTS: The risk for spontaneous abortion in female semiconductor workers was not significantly higher for fabrication and packaging process workers than for clerical workers. However, when we stratified by time period, the odds ratio for spontaneous abortion was significantly higher for packaging process workers who became pregnant prior to 2008 when compared with clerical workers (odds ratio: 2.21; 95% confidence interval: 1.01–4.81). CONCLUSIONS: When examining the pregnancies of female semiconductor workers that occurred prior to 2008, packaging process workers showed a significantly higher risk for spontaneous abortions than did clerical workers. The two semiconductor production periods in our study (prior to 2008 vs. after 2009) had different automated processes, chemical exposure levels, and working environments. Thus, the conditions prior to 2008 may have increased the risk for spontaneous abortions in packaging process workers in the semiconductor industry. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40557-017-0204-x) contains supplementary material, which is available to authorized users.

Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

PURPOSE: The purpose of this study was to compare needle aspiration and vacuum-assistedbiopsy in the ultrasound-guided treatment of lactational breast abscesses. METHODS: Between January 2005 and December 2014, a total of 74 patients presented withlactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated withneedle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student's t test and the chi-square test were used to compare the variables. RESULTS: No significant difference was found in the cure rate between the needle aspirationgroup (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days) than in the needle aspiration group (9.0 days) (P=0.001). CONCLUSION: Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses.

Maternal Hypotension with Regional Anesthesia for Elective Cesarean Delivery: Risk factor and Impact on Neonate Outcome

PURPOSE: This study was performed to determine the prevalence and risk factor of hypotension among pregnant women undergoing elective cesarean section under regional anesthesia, and whether hypotension has any impact on neonate outcome. METHODS: Retrospective analysis of 440 mother-infant pairs after elective cesarean section under regional anesthesia. Data collection included information on maternal blood pressure during the cesarean section, cord blood pH and Apgar score. RESULTS: This study revealed that 20.5% of the mothers underwent a decrease in mean arterial blood pressure by ≥30% and 1.1% of the mothers underwent a decrease in mean arterial blood pressure by ≥50%. Hypotension was more severe among the mother in those with preoperative hypertension and high body weight. The occurrence of maternal hypotension during cesarean section were not found to predict any complications like low Apgar score, need for oxygen treatment, even though fetal cord blood pH. CONCLUSION: Despite a maternal hypotension during elective cesarean section under regional anesthesia, healthy term infants seem to tolerate decreased placental blood perfusion.

Uterine arteriovenous malformation with positive serum beta-human chorionic gonadotropin: Embolization of both uterine arteries and extra-uterine feeding arteries

The incidence of uterine arteriovenous malformation (AVM) is rare. However, it is clinically significant in that it can cause life-threatening vaginal bleeding. We report a case of a large uterine AVM with positive serum beta-human chorionic gonadotropin. A presumptive diagnosis was made; a uterine AVM accompanied by, early pregnancy or retained product of conception. Because this uterine AVM was extensive, transcatheter arterial embolization of both uterine arteries and extra-uterine feeding arteries was performed. Three months after undergoing transcatheter arterial embolization, complete resolution of the uterine AVM was confirmed without major complication.

Aortic dissection accompanied by preeclampsia in a postpartum young woman

Aortic dissection is very rare in obstetrics, but it is a fatal disease. A 37-weeks primigravida woman with dyspnea and pitting edema presented to our emergency room. The patient was diagnosed with preeclampsia and underwent an emergency cesarean section under spinal anesthesia. The patient complained of severe dyspnea after the cesarean section, and the chest computed tomography scan was done. With the finding of aortic dissection, cardiopulmonary arrest occurred 5 hours after the cesarean section, and the patient died without reaction to cardio-pulmonary resuscitation. If a patient with preeclampsia complains of severe dyspnea or chest pain, aortic dissection needs to be suspected and a diagnosis should not be delayed.

Aortic dissection accompanied by preeclampsia in a postpartum young woman

Aortic dissection is very rare in obstetrics, but it is a fatal disease. A 37-weeks primigravida woman with dyspnea and pitting edema presented to our emergency room. The patient was diagnosed with preeclampsia and underwent an emergency cesarean section under spinal anesthesia. The patient complained of severe dyspnea after the cesarean section, and the chest computed tomography scan was done. With the finding of aortic dissection, cardiopulmonary arrest occurred 5 hours after the cesarean section, and the patient died without reaction to cardio-pulmonary resuscitation. If a patient with preeclampsia complains of severe dyspnea or chest pain, aortic dissection needs to be suspected and a diagnosis should not be delayed.

Relationship between M-Protein of Multiple Myeloma and False Positive Syphilis Serological Results / 中国实验血液学杂志

<p><b>BACKGROUND</b>The false positive in conventional syphilis serological test was found in patients with multiple myeloma (MM).</p><p><b>OBJECTIVE</b>To investigate the relationship between the M-protein of patients with MM and the false positive in conventional syphilis serologic test.</p><p><b>METHODS</b>The M-protein of 68 MM cases was typed with immunofixation electrophoresis and 68 cases of MM were screened with non-specific and specific syphilis serologic tests, then the samples with syphilic serological positive were chosen and confirmed with immonobloting test, finally the relationship between M protein of MM and the false positive of syphilis serological test were analysed.</p><p><b>RESULTS</b>Four out of 68 cases showed the positive in syphilis serological test and further were confimed to be false positive by immunoblotting test, the false positive rate was nearly 6%. The M-protein of MM patients in our hospital mostly possessed IgG, κ type, followed by IgA, κ type, light chain κ type. In general, κ : λ = 2.4 : 1. Among samples of 4 cases with syphilis serological positive 2 cases were of IgG and κ type, 1 case was of IgG, λ type, another 1 case was IgA, κ type.</p><p><b>CONCLUSION</b>The M-protein of IgG and IgA types in MM patients results in syphilis serological false positive reaction. The clinicians and laboratorial technicians should pay a great attention to screen the MM patients for the false positive syphilis serological test so as to avoid the misdiagnosis and subsequent embarassment.</p>

The effect of fine care on newborn with severe pneumonia combining with respiratory failure / 中国医学装备

Objective: To discuss the influence of the fine care for newborn with severe pneumonia (SPIN) combining with respiratory failure (RF). Methods: 60 cases of SPIN with RF were selected and divided into the observation group and the control group. 28 cases of SPIN with RF in the observation group were received fine care observation group after treatment, in which 16 cases were male children and 12 cases were female children. The ages of these children were from 10d to 28d day, and their average age was 18.26 + 4.16 d. The weight was from 2.4kg to 4.4 kg, and their average weight was 3.11 + / - 0.44 kg. 32 cases of SPIN with RF in the control group were received routine nursing, in which 14 cases were male children and 18 cases were female children. The ages of these children were from 10d to 28d and their age was (10 ~ 28) d. Their average age was (18.33 + 4.07) d. The weight was from 2.4kg to 4.4 kg, and their average weight was 3.08 + / - 0.46 kg. Then we analyzed espectively respectively on two groups of children with pH, arterial blood gas analysis index of oxygen partial pressure (PaO2), arterial partial pressure of carbon dioxide (PaCO2), respiratory rate (RR) and heart rate (HR) level and the total time of mechanical ventilation, the incidence of adverse circumstance and nursing satisfaction. Results: The observation group with pH, PaO2, PaCO2, RR and level of HR after fine care is superior to the control group, and the differences were statistically significant difference (t= 4.36, 3.83, 2.23, 12.11, 5.45; P <0.05). The total time of mechanical ventilation in the observation group was significantly lower than the control group, and the difference was statistically significant difference (t=7.63, P<0.05). The reintubation rate of the observation group was obviously lower than the control group and the difference was statistically significant (x2=3.83, P<0.05). Family satisfaction of nursing in the observation group was obviously higher than that in the control group, and the difference was statistically significant (x2=18.49, P<0.05). Conclusion: Fine care can effectively improve the SPIN with RF with blood gas analysis index, shorten the time of mechanical ventilation therapy, alleviate the pain and reduce reintubation rate. It has higher clinical value.

Practice patterns in the management of threatened preterm labor in Korea: A multicenter retrospective study

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.

A Case of Maternal Herpes Simplex Virus Type 2 Encephalitis without Genital Skin Lesion / 대한주산의학회잡지

Herpes simplex encephalitis is the most common form of encephalitis, but herpes simplex virus type 2 (HSV-2) encephalitis is very rare during pregnancy. In immunocompetent patients, HSV-2 encephalitis is usually mild. With early diagnosis and prompt initiation of antiviral treatment, as well as enhanced neurocritical care, a favorable outcome can be expected in both mother and neonate. We report a rare case of maternal HSV-2 encephalitis diagnosed by polymerase chain reaction following appendectomy. The woman had no symptomatic genital lesion, and the infant was not infected.

Portal Vein Thrombosis during Pregnancy / 대한주산의학회잡지

Portal vein thrombosis complicating pregnancy is a rare occurrence. The etiology of portal vein thrombosis is highly diverse. A 31-year-old multigravida was diagnosed with acute portal vein thrombosis at 12 weeks of gestation by ultrasound examination. She had epigastric and left upper quadrant pain, but there was no significant medical or surgical illness in the past. Laboratory studies showed no evidence of a thrombophilia. She was managed with anticoagulants and labor was induced at 38 weeks because of premature rupture of membranes. She delivered a healthy neonate without any complications. It seems that the cause of this thrombotic event was the hypercoagulable state of pregnancy.

Spontaneous Uterine Rupture during Second Trimester Pregnancy after High-intensity Focused Ultrasound / 대한주산의학회잡지

Uterine rupture during pregnancy does not occur frequently, but is associated with high rates of maternal and perinatal morbidity and mortality. As a non-invasive and conservative approach, high-intensity focused ultrasound (HIFU) has received attention from both gynecologists and patients for the treatment of fibroids, especially women who wish to preserve uterus. However, there are not enough studies about complication and prognosis related pregnancy after HIFU. We present a case of uterine rupture that occurred in second trimester who had been HIFU 3months before pregnancy.

The effect of time interval between a single course of antenatal corticosteroids and delivery on outcomes in preterm neonates / 대한산부인과학회지

OBJECTIVE: To determine whether the beneficial effects of a single course of antenatal corticosteroids for neonatal morbidity change with time METHODS: A retrospective chart review was performed of women who received a single complete course of antenatal corticosteroid and delivered a viable singleton infant between 26 and 35 weeks of gestation. Patients were divided into 1 of 3 groups on the basis of the interval from first corticosteroid dose to delivery (48 hr~7 days, 8~14 days and > or =15 days). Neonatal morbidities were compared between each groups. RESULTS: Two hundred three pregnancies were included, of which 78 women delivered at 48 hr-7 days, 65 women delivered at 8~14 days and 60 women delivered at > or =15 days. The 3 groups were similar in clinical characteristics and indications for antenatal steroids and delivery. Neonates delivered within 7 days had a lower incidence of receiving ventilatory support for more than 24 hours than 8~14 days group (32.1% vs 50.8%, P=0.023) and > or =15 days group (32.1% vs 51.7%, P=0.02). But there were no significant differences between the groups in ventilator days, surfactant use, oxygen dependency at 36 weeks of gestation, oxygen dependency at 28 days after delivery, intraventricular hemorrhage, necrotizing enterocolitis, sepsis and length of hospital days. There were no periventricular leukomalacia and neonatal death in all groups. CONCLUSION: Neonates delivered more than 7 days after first corticosteroid dose needed more short-term ventilatory support, but there were no differences in other neonatal outcomes.

Preliminary separation of the growth factors in platelet-rich plasma: effects on the proliferation of human marrow-derived mesenchymal stem cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Platelet-rich plasma (PRP) as a storage vehicle of growth factors has been successfully used in clinical applications, but in most cases the platelets were autologous. However, the large volume of blood withdrawn has detrimental effects on patients with anemia or poor general health. To overcome these limitations, this study was designed to separate the growth factors in homologous platelet-rich plasma.</p><p><b>METHODS</b>The gel chromatography with Superdex-75 column was applied to separate PRP supernatants into 4 major fractions. Then the four fractions were vacuumed freeze-dried and re-dissolved in phosphate buffered saline. Proteins concentrations in PRP and in four fractions were detected by bicinchoninic acid protein assay; platelet derived growth factor-AB (PDGF-AB) and transforming growth factor beta1 (TGF-beta1) levels were determined by sandwich enzyme-linked immunosorbent assays. The effects of fractions on the proliferation of human marrow-derived mesenchymal stem cells (MSCs) were determined by 3-(4, 5- dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay.</p><p><b>RESULTS</b>PRP supernatants were separated into four major fractions by gel chromatography. The proteins recovery was 96.72%. Of the four fractions, fraction B contained the highest TGF-beta1 and PDGF-AB levels, and the highest proteins concentrations. Cell proliferation curves of MSC demonstrated that fraction B and C induced a remarkable increase of MTT values compared to the untreated culture (P < 0.05), and the effects of fraction B and C showed no significant difference compared to the PRP group (P > 0.05). Fraction A and D showed no significant difference to the negative control group (P > 0.05).</p><p><b>CONCLUSIONS</b>The growth factors in PRP supernatants could be preliminarily separated into four fractions by gel chromatography, and the freeze-drying fractions retained the biological activity of growth factors. The growth factors were mostly presented in fraction B and C, and they promoted cell proliferation effectively.</p>

Expression of growth hormone secretagogue receptor type 1a in visceral vagal and spinal afferent pathways / 生理学报

In this study, the expressions of growth hormone secretagogue receptor type 1a (GHS-R1a) in the rat dorsal root ganglion (DRG) and nodose ganglion (NG) were investigated by using immunohistochemistry and in situ hybridization. The results clearly showed the presence of GHS-R1a mRNA and GHS-R1a-positive neurons in the rat DRG and NG. GHS-R1a was also co-localized with calcitonin gene-related peptide (CGRP) in some DRG and NG neurons, indicating the existence of subpopulations of the visceral afferents. The extrinsic primary afferent visceroceptive DRG and NG neurons from the stomach were identified by retrograde tracing fluorogold and stained for GHS-R1a and CGRP. Some neurons both positive for CGRP and GHS-Rla were labled by fluorogold. Our results not only demonstrate the expression of GHS-R1a in the vagal afferents but also provide the first and direct morphological evidence for its presence in the spinal visceral afferents, and gherin might have a modulatory role in the visceral afferent signaling.

A case of fetal intracranial hemorrhage diagnosed by antenatal ultrasonographic examination / 대한주산의학회잡지

Fetal intracranial hemorrhage is quite rare. Antenatal fetal intracranial hemorrhage may occur spontaneously, or in association with various maternal or fetal conditions. Currently, antenatal fetal intracranial hemorrhage may be diagnosed by imaging techniques including ultrasonography and less frequently, magnetic resonance imaging (MRI). We report a case of spontaneous fetal intracranial hemorrhage that was diagnosed antenatally in the third trimester with a brief review of literatures.

Systematic Evaluation in Hospitalization in Mildly Preeclamptic Women whose Placental Dysfunction was Exacerbated / 대한주산의학회잡지

OBJECTIVES: To compare the systematic evaluations in hospitalization of mildly preeclamptic women whose placental dysfunction was exacerbated with those whose placental dysfunction was not exacerbated. METHODS: There were seventy six mildly preeclamptic women after systematic evaluations in hospitalization, in which twenty eight women showed exacerbated placental dysfunction. Outcome markers considered suggestive of exacerbation of placental dysfunction included oligohydramnios (amniotic fluid index less than 5 cm), clinical diagnosis of intrapartum fetal distress and progression to severe preeclampsia. A clinical diagnosis of fetal distress was made when the monitoring revealed recurrent late, persistent tachycardia with loss of variability or prolonged decelerations. RESULTS: There were no significant differences in the amount of 24 hours urine protein, the concentrations in serum protein, creatinine, aspartate transaminase and alanine transaminase and hematocrit. But in exacerbated group, the concentrations of serum albumin and urine creatinine and creatinine clearance were significantly lower and the concentrations of serum uric acid and lactate dehydrogenase were significantly higher than not exacerbated group. CONCLUSION: In mildly preeclamptic women diagnosed after systematic evaluation in hospitalization, we must give attention to those whose concentrations of serum albumin and urine creatinine and creatinine clearance are low and concentrations of serum uric acid and lactate dehydrogenase are high.