RESUMO
【Objective】 To retrospectively analyze the irregular antibodies in 6 blood group systems other than the Rh blood group system in 53 pregnant women and analyze its correlation with the occurrence of hemolytic disease of the newborn(HDN). 【Methods】 19 473 pregnant women were screened for irregular antibodies by microgel detection technology combined with anti-human globulin (IgG+ C3d), and the positive samples screened out were further confirmed to understand the types and titers of irregular antibodies. Irregular antibody type determination experiment: IgG type irregular antibody titer was determined after mercaptoethanol (2-Me) inactivated the serum of the irregular antibody positive specimen, and then IgG and IgM type were determined by comparing the titer levels of irregular antibody. Three hemolysis tests and total bilirubin tests were performed on umbilical cord blood during delivery to analyze the level of jaundice and the occurrence of HDN. 【Results】 53 cases of irregular antibodies other than the Rh blood group system were detected in 19 473 pregnant women, with a positive rate of 0.27%, mainly MNS and Lewis blood group system.The incidence of HDN was 39.6% (21/53). There were 27 cases of IgM, 7 IgG, and 19 IgM + IgG. Comparison of total bilirubin detection between the low titer group (≤8) and the high titer group (>8) : the latter was significantly higher than the former (P<0.05); IgG antibody subtypes: IgG1 of the latter significantly increased (P<0.05), and so was IgG3 in former (P<0.05). There was a significant positive correlation between IgG1, IgG3 and total bilirubin. The area under the curve of IgG1+ IgG3 for HDN diagnosis, the sensitivity and specificity were 0.953, 0.900, and 0.967, respectively. 【Conclusion】 Other than Rh blood group system, irregular antibodies are mainly distributed in MNS and Lewis blood group system. The incidence of HDN is higher in Kell, Duffy and Kidd blood group systems after producing irregular antibodies. Non-antibody types are mostly IgM type or IgM + IgG mixed, and the incidence of HDN is not high; Patients with poor maternal history, either high or low titer, can be classified into IgG1 and IgG3 in early stages, and those with Abnormal results should be included into the perinatal management of high-risk women with regular checking.
RESUMO
Objective:To investigate the clinical efficacy and safety of Zhibitai capsule in the treatment of senile hyperlipidemia patients with phlegm and blood stasis syndrome.Methods:From June 2014 to June 2015, 126 elderly patients with primary hyperlipidemia of phlegm and blood stasis syndrome admitted to Hangzhou Hospital of Traditional Chinese Medicine were randomly divided into control group and observation group, with 63 cases in each group.The patients in the control group were given basic treatment plus atorvastatin calcium tablets, and the patients in the observation group were treated with Zhibitai capsule on the basis of the control study.Both two groups received continuous treatment for 12 weeks.The clinical efficacy, TCM syndrome integral, blood lipid, hemorheology and adverse reactions of the two groups were observed.Results:The total effective rate in the observation group was 92.1%(58/63), which was higher than 81.0%(51/63) in the control group, and the difference was statistically significant(χ 2=8.199, P<0.05). After treatment, the TCM syndrome score of the observation group was (9.31±1.78)points, which was lower than that of the control group[(15.88±2.35)points], and the difference was statistically significant( t=17.689, P<0.05). After treatment, the levels of total plasma cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the observation group were (5.16±0.28)mmol/L, (1.89±0.21)mmol/L, (3.34±0.11)mmol/L and (1.18±0.13)mmol/L, respectively, which in the control group were (5.31±0.15)mmol/L, (2.22±0.20)mmol/L, (3.47±0.16)mmol/L and (1.11±0.12)mmol/L, respectively, the differences between the two groups were statistically significant( t=3.748, 9.032, 5.314, 3.140, all P<0.05). After treatment, the whole blood low shear viscosity, high shear viscosity, plasma viscosity and fibrinogen in the observation group were (10.68±2.38)mPa/s, (4.11±0.31)mPa/s, (1.33±0.22)mPa/s, (3.01±0.22)g/L, respectively, which in the control group were (11.55±2.39)mPa/s, (4.43±0.30)mPa/s, (1.61±0.25)mPa/s, (3.25±0.22)g/L, respectively, the differences between the two groups were statistically significant( t=2.047, 5.888, 6.674, 6.123, all P<0.05). There was no statistically significant difference in the adverse reactions between the two groups( P>0.05). Conclusion:Zhibitai capsule can effectively improve the clinical efficacy, improve TCM syndromes, reduce blood lipids and improve hemorheology parameters in elderly patients with hyperlipidemia syndrome of phlegm and blood stasis syndrome, with no obvious adverse reactions, which is worthy of clinical promotion.
RESUMO
Objective To investigate the situation and the causes of neonatal death in Henan Province.Methods This study retrospectively analyzed the clinical data of 277 neonates who died at 18 hospitals in Henan Province in 2017.Distribution and causes of neonatal deaths,differences between perinatal conditions of premature and term/post-term infants,causes of early (＜ 7 d) and late (7-28 d) neonatal deaths and the differences in neonatal death cases between Maternal and Child Health Care Hospitals and General/Children's Hospitals were analyzed.We used t,rank-sum and Chi-square test (or corrected Chi-square test,or Fisher's exact test) for statistical analysis.Results (1) A total of 50 993 newboms were admitted to the 18 hospitals in 2017,297 of which died with a mortality of 5.82‰.After excluding 20 cases with uncertain birth or maternal pregnancy history or clinical data,277 cases with complete data were analyzed.Among them,168 (60.6％) were preterm neonates and 109 (39.4％) were term/post-term ones.Early and late neonatal deaths accounted for 74.0％ (205 cases) and 26.0％ (72 cases),respectively.(2) The top five causes of neonatal deaths were infection (78 cases,28.2％),asphyxia (54 cases,19.5％),neonatal respiratory distress syndrome (NRDS,33 cases,11.9％),severe congenital malformations (26 cases,9.4％) including cyanotic congenital heart diseases,digestive malformations,airway malformations and neural tube defects and pulmonary hemorrhage (23 cases,8.3％).Among them,the top three causes of early neonatal deaths were asphyxia (48 cases,23.4％),infection (43 cases,21.0％) and NRDS (33 cases,16.1％),while the main causes of late neonatal deaths were infection (35 cases,48.6％),major congenital malformations (9 cases,12.5％) and chromosome abnormities/inherited metabolic diseases (7 cases,9.7％).(3) Maternal complications during pregnancy accounted for 79.1％ (219 cases) and the predominant types were pregnancy-induced hypertension (43 cases,19.6％),followed by infection (36 cases,16.4％),placental-related conditions (32 cases,14.6％),gestational diabetes mellitus (23 cases,10.5％),hypothyroidism (20 cases,9.1％),fetal distress (18,8.2％),twin-twin transfusion syndrome (10 cases,4.6％) and cholestasis syndrome (9 cases,4.1％).(4) Compared with the term/post-term cases,the preterm cases had higher proportions of multiple births [27.4％ (46/168) vs 6.4％ (9/109),x2=14.016,P ＜ 0.05],assisted reproduction [7.1％ (12/168) vs 0.9％ (1/109),x2=4.421,P ＜ 0.05] and maternal hypertensive disorders of pregnancy [21.4％ (36/1 68) vs 6.4％ (7/109),x2=11.353,P ＜ 0.05],infection [16.7％ (28/168) vs 7.3％ (8/109),x2=4.295,P ＜ 0.05] and twin-to-twin transfusion syndrome [6.0％ (10/168) vs 0.0％ (0/109),x2=6.707,P ＜ 0.05].(5) Among all the early neonatal deaths,preterm cases had a higher incidence of NRDS than term/post-term neonates [20.3％ (27/133) vs 8.3％ (6/72),x2=1 1.937,P ＜ 0.05],but lower incidence of meconium aspiration syndrome (MAS),severe congenital malformations and chromosome abnormalities/inherited metabolic diseases [0.8％ (1/133) vs 5.6％ (4/72),x2=4.508;3.8％ (5/133) vs 16.7％ (12/72),x2=10.233;1.5％ (2/133) vs 6.9％ (5/72),~=4.172;all P ＜ 0.05].Among the late neonatal deaths,the incidence of severe intracranial hemorrhage in preterm infants was higher than that in term/post-term neonates [7.1％ (3/42) vs 0.0％ (0/30),x2=2.205,P ＜ 0.05].(6) Compared with the cases in General/Children's Hospitals,those in Maternal and Child Health Care Hospitals showed a higher proportion of preterm neonatal deaths [67.3％ (105/156) vs 52.1％ (63/121),x2=6.010,P ＜ 0.05],younger gestational age [(32.8±5.3) weeks vs (34.6±4.9) weeks,t=3.072,P ＜ 0.05],lower birth weight [(2 132.6± 1 014.5) g vs (2 409.4±987.3) g,t=-2.513,P ＜ 0.05],and higher average age of death [M(P25-P75),3 (1-8) d vs 2 (1-4) d,Z=3.710,P ＜ 0.05].Conclusions Neonatal death occurs mainly within one week after birth in those with maternal complications.Late preterm deaths and term/post-term cases account for nearly half of total neonatal deaths.The causes of death for preterm and term/post-term newborns vary with postnatal age.Infection,asphyxia and severe congenital malformations are important causes of neonatal deaths.
RESUMO
[Objective] To observe the effects of regulating Qi and strengthening spleen on the patients of chronic ulcerative colitis.[Methods] 38 patients of chronic ulcerative colitis(UC)were randomized and divided into experiment group(20 patients)and control group(18 patients)according to the selected standard.The patients of experiment group were treated with complex prescription of regulating Qi and strengthening spleen,the patients of control group were treated with granules of Mesalazine.To observe the symptom of accumulated points and enteroscope appearance on two groups.[Results] The difference on the symptom of accumulated points of experiment group exceeded the control group(P0.05).[Conclusion] There is effect of regulating Qi and strengthening spleen on the patients of chronic UC.
RESUMO
Objective To characterize the effects of Sanchi on the alcoholic hepatopathy rats.Methods 70 SD male rats were randomly divided into five groups:normal group(n=10),control group(n=15),high-dose Sanchi group(n=15),low-dose Sanchi group(n=15),and Tiopronin group(n=15).In order to induce alcoholic hepatopathy,animals in the control,high-dose and low dose Sanchi,and Tiopronin groups were orally dosed with HongXing ErGuoTou(56% ethanol;5g/kg),corn oil(2ml/kg),and pyrazole(27.2 mg/kg)every morning for 14 weeks.Rats in high-dose Sanchi,low dose Sanchi,and Tiopronin groups,were treated every afternoon during the 14-week induction of hepatopathy,with 1.2g/kg Sanchi,0.6g/kg,and 100mg/kg Tiopronin,respectively.All rats were sacrificed 12 hours following the last injection.Blood samples were obtained prior to euthanization.Blood-fat and serum lipoidase activity were measured using an automatic blood biochemical analyzer.Blood haluronic acid(HA),laminin(LN)were determined by ELISA.Histopathological changes of hepatic tissues(i.e.steatosiss,inflammation,and fibrosis)were assessed by microscopic examination of HE and Masson staining of the right lobe of livers.Results Compared with rats from the normal group(treated with ddH2O),rats in the control group have significantly higher steatosis,inflammation,liver fibrosis,and increased level of serum cholesterol,HDL-C,LDL-C,haluronic acid,laminin and AST/ALT activity,(P0.05).More importantly,treatment with high-dose,low-dose Sanchi,or Tiopronin resulted in less severe steatosis,inflammation,fibrosis in the liver,and reduced the levels of serum haluronic acid,laminin(P0.05).Conclusions(1)Daily dosing of alcohol,corn oil,and pyrozole for 14 weeks faithfully replicated the alcoholic hepatopathy symptoms observed in the ALD model,such as hepatic steatosis,immune cell infiltration,blood-fat disturbance,increase in serum AST/ALT activity,and liver fibrosis.(2)Sanchi can significantly alleviate the symptoms in the alcoholic hepatopathy rats including steatosis,improve hepatic function and fibrosis.