Effect of self-made traditional Chinese medicine decoction on pregnancy outcome in patients with hypertensive disorder complicating pregnancy / 中国中西医结合急救杂志

Objective To investigate the effect of self-made traditional Chinese medicine(TCM) decoction on pregnancy outcome in patients with hypertensive disorder complicating pregnancy. Methods A total of 124 pregnant hypertensive patients admitted to the Department of Critical Care of Guizhou Provincial People's Hospital from October 2016 to October 2018 were enrolled. The 62 patients who were treated with western medicine conventional method;62 patients who were treated with self-made TCM decoction on the basis of western medicine conventional method. The western medicine conventional treatment group was given magnesium sulfate combined with nicardipine; the self-made TCM treatment group was supplemented with TCM decoction on the basis of conventional western medicine treatment (composition: uncaria, raw oyster 20 g, gastrodia elata, eucommia, salvia miltiorrhiza, medlar rehmannia glutinosa each 15 g, rhizoma, mulberry parasitic, astragalus, ophiopogonis each 10 g. Severe headache and dizziness plus tortoise shell, gentian grass 15 g, anemarrhenae 10 g; severe edema plus cassia twig, aristolochiae 15 g, astragali, ginger skin 10 g), be decocted in water for oral dose, morning and evening oral, one dose a day, 1 week for a course of treatment, the two groups were continued for 4 weeks after the evaluation of clinical efficacy. The changes of blood pressure and blood coagulation parameters, placental bed arterial hemodynamics, pregnancy outcome index were observed before and after treatment; antihypertensive effects and adverse reactions after treatment were recorded. Results After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), Fibrinogen (Fib), placental bed arterial pulsation index (PI), end-systolic blood flow velocity and end-diastolic blood flow velocity ratio (S/D) and resistance index (RI) in both groups were lower than those before treatment, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly longer than before treatment, and the time-averaged flow rate (TAV) increased than that before treatment; SBP, DBP, Fib, PI, S/D and RI were significantly lower in self-made TCM treatment group than those in western medicine conventional treatment group [SBP (mmHg, 1 mmHg = 0.133 kPa): 114.26±17.07 vs. 132.72±17.64, DBP (mmHg): 82.98±6.24 vs. 90.09±6.48, Fib (g/L): 3.21±0.45 vs. 3.64±0.31, PI: 0.59±0.14 vs. 0.75±0.15, S/D: 1.70±0.21 vs. 1.93±0.25, RI: 0.43±0.08 vs. 0.54±0.12, all P < 0.05], PT, APTT, TAV in self-made TCM treatment group were significantly higher than western medicine conventional treatment group [PT (s): 12.26±0.57 vs. 11.72±0.44, APTT (s): 27.11±1.34 vs. 25.69±1.48, TAV (cm/s): 15.64±2.88 vs. 12.49±2.76, all P < 0.05]. The rate of cesarean section, postpartum hemorrhage, fetal heart abnormality and neonatal asphyxia in self-made TCM treatment group were significantly lower than those in western medicine conventional treatment group [cesarean section rate: 9.84% (6/61) vs. 27.78% (15/54), postpartum hemorrhage rate: 1.64% (1/61) to 14.81% (8/54), fetal heart abnormal rate: 3.28% (2/61) vs. 16.67% (9/54), the incidence of neonatal asphyxia: 1.64% (1/61) vs. 12.96% (7/54), all P < 0.05]. The total effective rate of the self-made TCM treatment group was significantly higher than that of western medicine conventional treatment group [98.39% (61/62) vs. 87.10% (54/62), P < 0.05]. However, there was no significant difference in the incidence of adverse reactions between the self-made TCM treatment group and western medicine conventional treatment group [16.39% (10/61) vs. 16.67% (9/54), P > 0.05]. Conclusion Self-made TCM decoction can improve the maternal and infant outcomes by improving the hypercoagulable state and placental hemodynamics in hypertensive patients with hyperthyroidism, the antihypertensive effect is remarkable and the safety is good.

Analysis of the effect of abortion of pregnant women with hypertensive disorders of COOK and Dinoprostone Suppositories on the balloon dilatation of the cervix during pregnancy / 中国生化药物杂志

Objective To investigate the effect of pregnant women with hypertensive disorders of COOK cervical dilatation balloon and Dinoprostone Suppositories on the gestation effect and safety of induction.MethodsThe research object from June 2013 to June 2015 in our hospital for pregnant women with hypertensive disorders in pregnancy in 68 cases (all patients with gestational hypertension and mild preeclampsia) were randomLy divided into the observation.Group and control group, 34 cases in each group.The observation group received COOK cervical dilatation balloon induced labor, the control group to implement Dinoprostone Suppositories induction, comparative analysis of observation group and control group, maternal and perinatal situation, mode of delivery, the cervical Bishop score, the degree of pain.Resultsabnormal fetal heart and uterine hyperstimulation, uterine tonic contraction rate of observation group were significantly lower than the control group(P<0.05).The cesarean section rate in the observation group and the control group had no significant difference.After placement, the cervical Bishop score of observation group was significantly higher than that of control group(P<0.05).The pain degree of observation group was significantly lower than that in control group(P<0.05).ConclusionCOOK balloon dilatation of the cervix and Dinoprostone Suppositories, fewer complications, can significantly improve maternal, perinatal and cervical ripening score of Bishop.

Clinical Significance of Combined Detection of Serum Lp-PLa2, Hcy and CysC for the Diagnosis of Hypertensive Disorder Complicating Pregnancy / 现代检验医学杂志

Objeetive To investigate the clinical significance of combined detection of lipoprotein associated serum phospholipase A2 (Lp-PLa2),homocysteine (Hcy) and cystatin C (CysC) in the diagnosis of hypertensive disorders complicating pregnancy (HDCP).Methods From January 2013 to May 2016 in Changan Hospital,selected 113 cases of pregnancy induced hypertension patients as the observation group,and were divided into three group A,B and C (group A:55 cases of HDCP patients,group B:32 cases of mild preeclampsia and group C for patients with severe preeclampsia 26 cases).At the same period,selected 50 cases of normal college pregnancy as control group,serum Lp-PLa2 (enzyme-linked immunosorbent assay),Hcy (cyclophorase method) and CysC (particle enhanced turbidimetric method),the test results were analyzed and compared.Results Serum Lp-PLa2,Hcy and CysC test results in the control group,the observation group A,observation group B and observation group C increased significantly,in the observation group C increased most obviously.Compared with the control group,the serum levels of Lp-PLa2,Hcy and CysC in the observation group were significantly higher,the difference was statistically significant (F=8.102,7.231 and 6.926,all P＜0.05).Pearson correlation analysis showed that there was a positive correlation between serum Lp-PLa2,Hcy and CysC and blood pressure (r=0.71,0.69,0.63,all P＜0.05).The abnormal rate of serum Lp-PLa2,Hcy and CysC for three joint detection was higher than that of single detection,and the difference was statistically significant (x2 =6.725,P＜0.001).The abnormal rate of serum Lp-PLa2,Hcy and Cys single test results increased with the exacerbation of HDCP,and the difference was statistically significant (x2=9.351,P＜0.000).Conclusion Serum Lp-PLa2,Hey,CysC and pregnancy would be closely related to the occurrence and development of hypertension syndrome,so combined detection of HDCP can improve the detection rate of abnormal results,and it has important clinical significance for early diagnosis and prognosis of HDCP.

Clinical effect of magnesium sulfate combined with nifedipine in hypertensive disorder complicating pregnancy / 中国生化药物杂志

Objective To investigate the clinical effect of magnesium sulfate combined with nifedipine in the treatment of patients with pregnancy induced hypertension( HDCP) .Methods Retrospective study was used in this study and 116 patients with HDCP from January 2013 to July 2015 in department of obstetrics and gynecology from our hospital were divided into two groups, including routine group of 62 patients who received routine treatment +magnesium sulfate) and combination group of 54 patients who received routine treatment +magnesium sulphate +nifedipine.The clinical effect was analyzed after five days’ continuous treatment.Results The systolic blood pressure, diastolic blood pressure,24h urinary protein, random urine protein /creatinine,serum homocysteine (Hcy) and CRP values in combination group were lower than routine group (P<0.05).There were no statistical difference in maternal uterine inertia, neonatal asphyxia, fetal distress, postpartum hemorrhage rate between the two groups after the treatment.But the rate of cesarean section in the combination group(50.00%)was significantly lower than that in the routine group(68.25%)(P <0.05).Conclusion Magnesium sulfate combined with nifedipine in the treatment of patients with HDCP had better antihypertensive effect, and would not increase fetal adverse birth outcomes incidence and significantly reduce the rate of cesarean section.

Association between diet during pregnancy and hypertensive disorder complicating pregnancy / 中华临床营养杂志

Objective To investigate the association between diet during pregnancy and hypertensive dis-order complicating pregnancy ( HDCP ) , so as to provide a theoretical basis guiding appropriate diet during pregnancy.Methods Using 1∶2 matched case-control study method, we selected pregnant women delivered in Anhui Women and Child Health Care Hospital from January to December 2014, and interviewed them with food frequency questionnaire.The relationship between intake frequency of various food and HDCP was analyzed. Results A total of 543 women were included in this study, including 181 cases and 362 controls.Mann-Whit-ney U test results showed that the frequencies of meat and fish, eggs, beans, nuts, milk, and pickled food con-sumption were significantly different between the cases and the controls (all P0.05).Multivariate Logistic regression analysis showed that higher intake frequencies of beans (OR=0.746, 95%CI:0.645-0.862), eggs (OR=0.789, 95%CI:0.693-0.898), and milk (OR=0.822, 95% CI:0.725-0.931) were associated with lower risk of HDCP; in contrast, higher intake fre-quency of pickled food was associated with higher risk of HDCP (OR=1.190, 95% CI:1.054-1.344). Conclusions Beans, eggs, and milk may be protective factors for HDCP, while pickled food may be risk fac-tor of HDCP.Diet during pregnancy should be appropriate and following scientific guidelines.

Relationship between B-tupe natriuretic peptide and preeclampsia of hypertensive disorder complicating pregnancy as well as its significance / 中国综合临床

Objective To investigate and evaluate the correlation between brain natriuretic peptide (BNP) and gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy (HDCP).Methods Fifty cases with HDCP and 46 cases with mild and 83 cases with sever stage preeclampsia were selected as our subjects.And 33 cases with regular pregnancy and 31 with irregular pregnancy were served as control group.Plasma brain natriuretic peptide,urinary protein quantity(UBQ),24-hour urinary protein assay (UPA) were measured.The correlations of brain natriuretic peptide and UBQ,UPA,systolic pressure (SP),diastolic pressure (DP) were analyzed.Results The levels of brain natriuretic peptide in the group with gestational hypertension and mild,severe preeclampsia groups were (48.54± 18.27),(79.46± 32.18) and (292.24±213.08) ng/L,higher than that in normal pregnancy and non pregnant group ((27.84± 14.58) and (20.63± 8.28) n/L;F =49.583,P＜0.05).While no significant difference exists between normal pregnancy group and non pregnant group.Grouped on the median values (199) of brain natriuretic peptide of the severe preeclampsia group,the levels of 24-hour UPA,systolic pressure and diastolic pressure were (5.46±2.68) g,(174.55± 13.58) mmHg,(113.74±9.91) mmHg in patients with brain natriuretic peptide ≥ 199 ng/L(n=42),significant higher than those in patients with brain natriuretic peptide ＜ 199 ng/L(n =41;(4.34± 1.95)g,(165.31±11.12) mmHg,(106.05±8.02) mmHg;t=2.603,3.396,2.308;P=＞0.010,0.001,0.024).The levels of 24-hour UPA,systolic pressure and diastolic pressure of patients with brain natriuretic peptide ≥ 86ng/L(n=20) in mild preeclampsia were (1.68±0.27) g,(163.69±8.29) mmHg,(105.45±6.71) mmHg,significant higher than those in patients with brain natriuretic peptide ＜ 86 ng/L (n =26;(1.16 ± 0.31) g,(152.90±7.32) mmHg,(99.19 ± 5.25) mmHg;t =3.180,2.508,2.32;P =0.010,0.016,0.025).Brain natriuretic peptide was closely correlated with UPA,systolic pressure and diastolic pressure in hypertensive disorder complicating pregnancy (HDCP) (r =0.29,0.30;P ＜ 0.01).Brain natriuretic peptide was closely correlated with UPA systolic pressure and diastolic pressure in mild preeclampsia (r =0.39,0.37,0.40;P ＜0.01).And correlation efficacy of brain natriuretic peptide with UPA,systolic pressure and diastolic pressure were 0.44,0.42 and 0.53 (P＜0.01).Conclusion The level of brain natriuretic peptide is closely associated with the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.Correlation of brain natriuretic peptide to the severity of gestational hypertension and preeclampsia is independent of urinary protein and hypertension.Brain natriuretic peptide is an important indicator for the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.

The quantitative determination of BKCa channels in placental arteriole smooth muscle cells of hypertensive disorder complicating pregnancy / 重庆医学

Objective To observe the change of protein levels of large conductance calcium activated potassium channel (BK‐Ca) in placental arteriole smooth muscle cells from hypertensive disorder complicating pregnancy and discuss its role .Methods Western blot analysis was used to examine protein expression of α subunit andβ1 subunit of BKCa channels in placental arteriole smooth muscle cells from hypertensive disorder complicating pregnancy .Results The relative protein expression level of α‐subunit in the HDCP group was 1 .001 2 ± 0 .169 8(n=15) ,and the NT group was 1 .028 2 ± 0 .180 6 (n=15) .There was no significant differences between the two groups (P> 0 .05);the relative protein expression level of β1 subunit in the HDCP group was 0 .418 1 ± 0 .080 8 (n=15) ,and the NT group was 1 .616 8 ± 0 .012 6 (n=15) ,theβ1‐subunit protein expression levels of HDCP group were significantly lower (P<0 .05) .Conclusion The protein expression ofβ1‐subunit ,but notα‐subunit ,was reduced in pla‐cental arteriole smooth muscle cells from hypertensive disorder complicating pregnancy .Therefore ,BKCa channel activity may have been involved in hypertensive disorder complicating pregnancy ;and the abnormal expression ofβ1 subunit maybe an important basis in hypertensive disorder complicating pregnancy .

Changes of levels of CD4+CD25+Foxp3+regulatory T cells in HDCP peripheral blood and its significance / 中国免疫学杂志

Objective:To investigate the changes of the levels of CD 4+CD25+Foxp3+regulatory T cells in HDCP peripheral blood and its significance.Methods: From 2013 January to 2014 August 46 hypertensive disorder complicating pregnancy ( HDCP ) patients treated in our hospital ,including 22 patients with mild preeclampsia ,24 cases of severe preeclampsia ,and 25 normal pregnant women,used flow cytometry detected each group patient peripheral blood CD 4+CD25+Foxp3+regulatory T cells.Results: Severe preeclampsia group CD4+CD25+T cell ratio was (5.01±1.04)%,lower than mild preeclampsia group (7.38±1.26)% and normal pregnant women group ( 12.59 ±2.48 )%, the difference was statistically significant ( P<0.05 );Mild preeclampsia and severe preeclampsia group CD4+CD25+Foxp3+T cell absolute number respectively were (0.96±0.11) ×107 and (0.63±0.12) ×107,CD4+CD25+Foxp3+Treg/CD4+T were (2.58±0.93)%and (1.84±0.85)%,were lower than that of normal pregnant women group (1.85± 0.17) ×107 and(5.11±0.99)%,the difference was statistically significant (P<0.05);Mild preeclampsia group and severe preeclampsia blood estriol were (6.16±2.17) mg/L and (3.27±1.15) mg/L,significantly lower than that of normal pregnant women group (11.34±2.4) mg/L,the difference was statistically significant (P<0.05).Conclusion: Hypertensive disorder complicating pregnancy diseases patient CD 4+CD25+Foxp3+regulatory T cells was significantly reduced ,but also serum estriol reduced ,which may be related to the pathogenesis of gestational hypertension disease and immune tolerance .

Effect of hypertensive disorder complicating pregnancy on neonate brain damage and brain development / 中华医学超声杂志（电子版）

ObjectiveTo analyze the craniocerebrum ultrasonographic images of the infants born by women with hypertension in pregnancy and investigate the effect of hypertension in pregnancy on neonate brain injury and brain development.MethodsTo assess the brain injury and brain development, 106 infants born by women with hypertension in pregnancy (study group) and 200 infants born by women without high risk factors during perinatal period (control group) in the neonatal intensive care unit of First Affiliated Hospital of Harbin Medical University between 2013 and 2014 underwent brain ultrasonography. The abnormal ultrasound images and the constitution of abnormal ultrasound images distribution in two groups were compared. The relationship between the abnormal ultrasound images and the degree of hypertension in pregnancy were analyzed.ResultsThe brain ultrasonographic result of the infants : (1) In the group with hypertension in pregnancy, the abnormal ultrasound images were found in 78 cases (73.6%). For the preterm infants, the solitary abnormality was found in 41 cases (25 cases of cerebral white matter injury, 14 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities were found in 15 cases; for the full-term infants, the solitary abnormality was found in 17 cases (12 cases of peri-intraventricular hemorrhage, 3 cases of hypoxic-ischemic encephalopathy and 2 case of brain hypoevolutism) and multiple abnormalities were found in 5 cases. (2) In the group without high risk factors, abnormalities were found in 73 cases (36.5 %). For the preterm infants, abnormal ultrasound images were found in 45 cases, including solitary abnormality found in 30 cases (24 cases of cerebral white matter injury, 4 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities found in 15 cases; for the full-term infants, the abnormal ultrasound images were found in 30 cases, including solitary abnormality found in 24 cases (10 cases of peri-intraventricular hemorrhage and 14 cases of hypoxic-ischemic encephalopathy) and multiple abnormalities found in 6 cases. (3) There were obvious statistical significances between the comparativeness of two groups (χ2=38.119,P<0.001), but there were no statistical significances in the constitution of the abnormal ultrasound images distribution between the two groups (χ2=0.552,P=0.759). (4) There were statistical significances between the comparativeness of the abnormal ultrasound images and the degree of hypertensive disorder complicating pregnancy (P<0.001). ConclusionCraniocerebrum ultrasonography is the first choice to detect and monitor brain abnormal and can provide basis for clinical diagnosis, treatment and intervention at early stage for the infants born by women with hypertension in pregnancy.

Sympathetic nervous activity and hypertensive disorder complicating pregnancy / 第二军医大学学报

Hypertensive disorder complicating pregnancy is a commonly seen pregnancy complication that may pose serious problem to maternity and infant health, and is one of the major causes for morbidity and mortality in pregnant women and neonates, with the specific etiology and pathogenesis remain unclear. Recent studies have found that sympathetic nervous activity hyperthyroidism plays a role in the pathogenesis of hypertensive disorders in pregnancy. This review focused on the relationship between the sympathetic nerve activity and hypertensive disorder complicating pregnancy.

Correlation between hypertensive disorder complicating pregnancy with homocysteine,DˉD and hsˉCRP / 国际检验医学杂志

Objective To investigate the relationship between hypertensive disorder complicating pregnancy(HDCP)with homo-cysteine,D-D and high sensitive C-reactive protein(hs-CRP).Methods 80 HDCP women included 38 cases of gestational hyperten-sion,26 cases of mild preeclampsia and 16 cases of severe preeclampsias,and at the same time 36 normal late-term pregnant women and 30 non-pregnant normal women were selected as the control group.The plasma Hcy was determined by the enzymatic cycling assay,D-D was determined by the latex immune turbidimetry and hs-CRP was determined by the nephelometry immuno assay,re-spectively.Results The plasma Hcy,D-D and hs-CRP levels in the HDCP group were significantly increased compared with the normal non-pregnancy women group and the normal late-term pregnancy women group controls and showed the increasing trend with the aggravation of disease condition,the differences had the statistical significance(P <0.01).Conclusion Timely monitoring the plasma Hcy,D-D and hs-CRP levels can effective conduct the adverse pregnancy prediction,thus timely takes the medication in-tervention for correcting the occurrence and development of the disease condition,and provides the significant reference indexes for evaluating the change and prognosis of the disease condition in clinic.

Changes and significance of serum ET-1 、TNF-α and VEGF in patients with hypertensive disorder complicating pregnancy / 中国基层医药

Objective To observe the changes of serum ET-1,TNF-α and VEGF in patients with hypertensive disorder complicating pregnancy ( HDCP),explore the significance of cytokines in HDCP and the relationship between cytokines and HDCP.Methods The serum levels of ET-1,TNF-α and VEGF in 60 patients with HDCP and 30 normal pregnant women were detected by ELISA.Results The serum levels of ET-1,TNF-o in HDCP group were higher than those of the control group( all P ＜0.05).The serum level of VEGF in HDCP group was lower than that of the control group ( P ＜ 0.05).Negative correlation was observed between VEGF and ET-1,TNF-α in HDCP group (P ＜ 0.05).Conclusion The serum levels of ET-1,TNF-α increased significantly,while the serum level of VEGF decreased.ET-1,TNF-α and VEGF may play important roles in ipathogenesis and development of HDCP.

Expression of serum TNF-α,IL-6 and MMP-9 in patients with hypertensive disorder complicating pregnancy and its significance / 中国基层医药

Objective To explore the effect of the serum tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6)and matrix metalloproteinase 9(MMP-9)in the pathogenesis of hypertensive disorder complicating pregnancy(HDCP).Methods The serum levels of TNF-α,IL-6 and MMP-9 in 50 patients with HDCP and 20 normal pregnant women were detected by ELISA.Results The serum levels of TNF-α and IL-6 in HDCP group were higher than the control group(t=4.16,4.38,all P＜0.05).The serum level of MMP-9 in HDCP group was lower than the control group(t=3.89,P＜0.05).Negative correlation was observed between TNF-α,IL-6 and MMP-9 in HDCP group(r=-0.372,-0.328,all P＜0.05).Conclusion The serum levels of TNF-α and IL-6 increased significantly,while the serum level of MMP-9 decreased.TNF-α,IL-6 and MMP-9 may play important roles in pathogenesis and development of HDCP.

Clinical analysis of risk factors of incidence of hypertensive disorder complicating pregnancy / 中国基层医药

Objective To investigate the risk factors of incidence of hypertensive disorder complicating pregnancy(HDCP)and provide reference for prevention and treatment of HDCP.Methods The clinical information of 2 217 cases of maternal delivery were retrospectively analyzed;The relevant social factors and obstetric factors of HDCP were analyzed.Results 186 cases of HDCP occurred in 2 217 cases of maternal,the incidence rate of HDCP was 8.4%.The single-factor analysis showed that the place of residence.prenatal system checks and parity had certain degree of contact with incidence of HDCP(χ2=11.2331,10.6781,5.4456,all P＜0.05),and the age,abortion history and parity had no significant correlation with incidence of HDCP(χ2=4.9201,3.0134,1.7301,all P＞0.05).Multivariate Logistic regression analysis showed that the rural living and no prenatal system check were risk factors of incidence of HDCP.Conclusion The maternal of rural living and no prenatal system check were the high-risk population of HDCP,and emphasis assessment and reasonable control these factors could reduce the incidence of HDCP.

Expressions of LKN-1,CCR1 and CCR3 in Placentas of Pregnant Women with Hypertensive Disorder / 实用妇产科杂志

Objective:To investigate the role of Leukotactin-1(LKN-1),CC receptor 1(CCR1)and CC receptor 3(CCR3)in the pathogenesis of hypertensive disorder complicating pregnancy(HDCP),the expressions of these factors in placentas were measured.Methods:The levels of LKN-1,CCR1 and CCR3 in placentas were measured from 32 patients with HDCP(study group)and 32 normal pregnant women(control group)by western blot(WB).The localization of these factorsin placentas were detected by immunohistochemistry(IHC).Results:LKN-1 protein expression was negative in placentas from the two groups by WB and IHC,while both CCR1 and CCR3 in the HDCP group were significantly lower than those in the control group(CCR1 0.66±0.06 vs 0.88±0.03.CCR3 0.17±0.01 vs 0.27±0.01,P<0.01).CCR1 was localized in vascular endothelial cells and stroma cells in both groups,but rare in the trophoblast layer.CCR3 was localized in vascular endothelial cells and trophoblast cells in both groups.Conclusions:There is no LKN-1expression in placentas from the two groups.Down regulation of CCR1 and CCR3 may associate with the pathogenesis of HDCP.

Changes of platelet activating factor to hypertensive disorder complicating pregnancy / 中国医师杂志

Objective To investigate the changes of platelet activating factor ( PAF) in serum from patients with hypertensive disorder complicating pregnancy .Methods The specimens from 138 women were obtained at Department of Obstetrics , Xinhua Hospital , School of Medicine , Shanghai Jiaotong Uni-versity, between June 2008 and March 2010.They were divided into two groups:women( n =63) with hy-pertensive disorder complicating pregnancy and normal pregnant women ( n =75 ) ( control group ) .All of them delivered until maturity .ELISA was used to detect the levels of PAF in those women's serum and in the umbilical cord serum .Results The levels of PAF in hypertensive disorder complicating pregnancy group (27.46 ±13.37 ) ng/ml were no significantly different from the control group (25.48 ±11.05 ) ng/ml( P >0.05 ) .With the hypertensive disorder complicating pregnancy more deteriorative , the levels of women ser-um PAF would be higher .The levels of women's serum PAF in hypertensive disorder complicating pregnancy group were significantly higher than the umbilical cord serum [0.00(0.00-8.83) ng/mL]( P <0.05). The levels of women's serum PAF in control group were also significantly higher than the umbilical cord ser -um[0.00(0.00-7.80)ng/mL]( P <0.05).Conclusion There are some relationships between PAF and hypertensive disorder complicating pregnancy .

Polymorphism of angiotension Ⅱ type 1 receptor gene, angiotensin converting enzyme gene and aldosterone synthase gene and hypertensive disorder complicating pregnancy / 中国综合临床

Objective To explore the relationship among genetic polymorphism of angiotension Ⅱ type 1 re-ceptor(AT1 R) A1166-C, angiotensin converting enzyme (ACE) insertion/deletion (I/D), aldosterone synthase (CYP11B2)-344T/C and hypertensive disorder complicating pregnancy.Methods Polymerase chain reaction-re-striction fragment length polymorphism (PCR-RFLP) assay was used to detect the genotypes of AT1 R A1166-C ,ACE (I/O) ,CYP11B2 -344T/C in 86 cases of hypertensive disorder complicating pregnancy and 175 cases of normal control.Results There was 18 combined types in hypertensive disorder complicating pregnancy cases and normal control cases.Compared to AT1R-AA + ACE-Ⅱ + CYP11B2-TT, Odds ratios (OR) of AT1R-AA + ACE-DO +CYP11B2-TC,AT1 R-AC + ACE-ID+CYP11B2-TC and AT1R-AC+ACE-DD+CYP11B2-TC are 7.289,5.315 and 5.694 respectively.There was no statistical significance among the others.Conclusion In all 18 kinds of combined types, AT1 R-AA + ACE-DO + CYP11B2-TC,AT1R-AC+ACE-ID+CYP11B2-TC and AT1 R-AC + ACE-DD +CYP11B2-TC might increase the susceptibility of hypertensive disorder complicating pregnancy.It is possible that multigenes are interacted in the etiology of hypertensive disorder complicating pregnancy.

Clinical study of 36 cases with severe pre-eclampsia complicated with ascites / 中国综合临床

Objective To analyse clinical characteristics and preventive methods of pregnancy-induced hypertensive severe pre-eclampsia with ascites.Methods 184 cases of patients with severe pre-eclampsia complicated with ascite were divided into two groups and the clinical characteristics were compared(severe pre-eclampsia complicated with ascite group,n=36;Severe pre-eclampsia group,n=148 cases).Results The average time of the termination of pregnancy was (34±4) weeks in severe pre-eclampsia complicated with ascites group,and (36±3) weeks in severe pre-eclampsia group (t=2.71,P＜0.01).There were 6 cases of intrauterine stillborn (16.67%),14 cases of neonatal mortality (38.89%);22 cases of premature labor (61.11%) in severe pre-eclampsia complicated with aacites group;There were 4 cases of intrauterine stillborn (2.7%);16 cases of neonatal mortality (10.81%);and 35 cases of premature labor (23.65%) in severe pre-eclampsia group (X~2=10.99,16.73,19.01,P＜0.001).There were differences in the total protein,albumin,white/ball ratio,lactic acid dehydregenase,serum creatinine,24-hour urinary protein between the two groups [total protein:(51.68±6.08) g/L vs (59.34±8.28)g/L,albumin:(24.32±4.06) g/L vs (32.16±5.63) g/L,white/ball ratio:(0.92±0.26) vs (1.16±0.26),lactic acid dehydrogenase:(495.87±312.56) U/L vs (323.81±185.00) U /L,serum creatinine:(131.62±95.34) μmol/L vs (91.52±86.83) μmol/L,24 h urinary protein(4.21±3.51)g/24 h vs (2.38±2.57)g/24h,t=6.17,8.77,5.50,4.79,2.72,3.98,P＜0.05 or ＜0.01].Conclusion Tbe condition of severe pre-eclampsia with ascites is extremely serious,so pregnancy should be timely terminated.The aacites can be dissipated after delivery.Early,systematic and regular prenatal care can prevent severe pre-eclampsia and complications in time.

Endogenous Ouabain in Hypertensive Disorder Complicating Pregnancy / 华中科技大学学报（医学）（英德文版）

Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy (HDCP) and 30 healthy pregnant women to investigate the effect of endogenous ouabain on HDCP. Compared with the healthy pregnant group, the expression of endogenous ouabain dramatically increased in the HDCP groups (P<0.01). There was a significantly positive correlation between the expression of en- dogenous ouabain with ET-1 (r=0.5567, P<0.01), while the correlation of endogenous ouabain and NO was significantly negative (r=-0.6895, P<0.01). As expected, the correlation between ET-1 and NO was negative (r=-0.7796, P<0.01). ET-1 concentrations of maternal and cord sera in HDCP groups were significantly higher in comparison with healthy pregnant group (P<0.01). On the con- trast, NO concentrations were much lower in the maternal and cord sera of HDCP groups as com- pared with healthy pregnant group (P<0.01). Our data suggest that endogenous ouabain is directly involved in the nosogenesis of HDCP, with accompanying decreased NO and the elevated of ET-1.

The Association between Polymorphism of TNF-α Gene and Hypertensive Disorder Complicating Pregnancy / 华中科技大学学报（医学）（英德文版）

To study whether the development of hypertensive disorder complicating pregnancy is associated with -308G→A, -850C→T mutation at promoter of TNF-α gene, the -308G→A, -850C→T polymorphism was examined in patients and healthy pregnant women by PCR-RFLP technique. The frequencies of genotype and allele were compared between the two groups. The re- sults showed that with -308G→A polymorphism distribution, the allele frequency of TNF2 and the frequency of the genotype TNF2/1 in the patient group was significantly higher in the patient group than in control group (P<0.05). A significant difference in genotype distribution of -850C→T poly- morphism was observed between the two groups. The allele frequencies of T in patient group was higher in the control group as compared with the patient group. The frequencies of CT and TT geno- types were lower in the patient group. It is concluded that the TNF2 allele of -308 is associated with the occurrence of hypertensive disorder complicating pregnancy, while T allele of -850 may be the protective factor against the development of the disease. TNF2/1 CC may be susceptibility genotype of hypertensive disorder complicating pregnancy.