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【Objective】 To investigate the transfusion ratio of plasma to RBC suspension during DIC caused by sever postpartum hemorrhage, so as to improve the clinical blood transfusion protocol. 【Methods】 A total of 82 parturients, who gave birth in our obstetrics department from January 2008 to December 2019 and treated successfully for DIC due to sever postpartum hemorrhage, were selected for the study. According to the plasma/RBC suspension ratio range (from 0.4 to 2.0) during DIC rescue, the included population was divided into four groups according to the ratio interval of 0.4: Group 1: 0.4~0.8 (13 people, median 0.7), Group 2 : 0.8~1.2(30 people, median 1.0), Group 3: 1.2~1.6(30 people, median 1.3), and Group 4: 1.6~2.0 (9 people, median 1.8). The general conditions, way of delivery, number of uterine artery perfusion embolization and surgical operations performed in the 4 groups were recorded. Once spontaneous postpartum hemorrhage occurred, blood cell analysis and coagulation function examinations were carried out every 1 to 2 hours until the condition was stable. The 24-hour blood loss, transfusion units of RBC suspension, fresh frozen plasma(FFP), platelet apheresis and fibrinogen during DIC and throughout the rescue of 4 groups were recorded and compared. Locally Weighted Regression (Lowess) method was applied to analyze the nonlinear association between the plasma/RBC suspension ratio and the duration of DIC, according to the duration of DIC in 4 groups. 【Results】 1) The shortest duration of DIC (326.15 min) was observed in DIC patients transfused with a plasma/ red blood cell suspension ratio=1.8. The duration of DIC (min) in the four groups were 505.21±259.53, 435.67±307.18, 420.93±259.43, and 247.86±215.77, respectively (P<0.05). 2) The coagulation indexes PT(s), INR, APTT(s) and Fib(g/L) gradually recovered between 2.9~13.9 h after transfusion in all four groups, especially in group 4 (median plasma/RBC suspension ratio of 1.8), whose changes were most pronounced in PT, INR, and Fib at 4.3 h, 2.9 h, and 5 h, respectively (P<0.05). 【Conclusion】 Fresh frozen plasma should be given as early as possible during blood transfusion treatment of DIC rescue. The increase of the ratio of plasma/RBC suspension is beneficial to the early recovery of DIC, and the optimal ratio of plasma to RBC suspension is 1.8.
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Objective To explore the changes and significance of serum visfatin (VF) levels in patients with preeclampsia (PE). Methods Eighty-one cases of PE were served as observed group, 39 cases of mild PE (mild PE group) and 42 cases of severe PE(severe PE group), 45 cases of normal pregnant women as control group. Fasting plasma glucose (FPG), fasting insulin (FINS), total cholesterol (TC) and triglyceride (TG) were measured and the homeostasis model assessment insulin resistance (HOMA-IR) were evaluated in these cases. The levels of serum VF were determined by enzyme-linked immunosorbent assay. Results There were no significant difference in the levels of FPG, FINS, HOMA-IR among three groups (P > 0.05). The levels of TG, TC were significantly increased in severe PE group compared with mild PE group or control group (P < 0.05). The level of serum VF in severe PE group [(22.45 ± 4.18) μ g/L]was significantly higher than that in control group [(14.52 ± 3.25) μg/L]and mild PE group [(18.75 ± 3.96) μ g/L](P < 0.05). The level of serum VF had no relationship with the levels of FPG, FINS (r = 0.21,0.24, P > 0.05), the positively correlation was found between the level of serum VF and HOMA-IR, TC, TG (r = 0.42,0.36,0.41, P < 0.05) in patients with PE. Conclusion VF elevates in the patients with preeclampsia and closely relates with the severity of PE, insulin resistance and lipid metabolism.
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Purpose To investigate the effects of oxytocin(OT) and prostaglandins intervention on oxytocin receptor(OTR) expression of primary culture of human myometrial smooth muscle cell.Methods Using respectively oxytocin, prostaglandin E2(PGE2),and prostaglandin F2alpha(PGF2alpha) intervened on human myometrial smooth muscle cell.The expression of OTR mRNA and protein of cell hemogenate was examined.Results The expression of OTR between oxytocin intervention group and untreated group was similar.The expression of OTR in cell was significantly higher in the PGE2 or PGF2alpha intervention group than that in the untreated group.The expression of OTR in cell was significantly higher in the PGE2 and PGF2alpha joint intervention group than that in the untreated group and than that in the PGE2 or PGF2alpha individual intervention group.Conclusion Oxytocin didn′t increse the expression of OTR in human myometrial smooth muscle cell.PGE2 and PGF2alpha incresed the expression of oxytocin receptor in human myometrial smooth muscle cell.Furthermore PGE2 and PGF2alpha joint intervention more significantly increased the expression of oxytocin receptor than PGE2 or PGF2alpha individual intervention in human myometrial smooth muscle cell.
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BACKGROUND: Astragalus root can inhibit apoptosis through reducing the release and interstitial accumulation of excitatory amino acids, alleviating calcium overloading and antioxidative effect.OBJECTIVE: Astragalus root was used to treat anoxic-ischemic brain injury in immature brain. We evaluated the effect of astragalus root on caspase-3 mRNA expression, and meanwhile, labyrinth test was employed to investigate the intervention of astragalus root on learning and memory function of mature rats after anoxic-ischemic brain injury.DESIGN: Randomized and controlled study.SETTING: Pediatric Department, Zhongda Hospital Affiliated to the Medical College of Southeast University; Pathological Department, the Basic Medical Sciences Institute of Southeast University.MATERIALS: From October 2002 to June 2003, this study was conducted at the Experiment Center of the Medical College, Southeast University.A batch of 114 seven-day-old SD rats were selected from the same brood and divided into 3 groups, namely, sham-operation group (n=18), model group (n=48) and astragalus root group (n=48). Astragalus injection was produced by Chengdu DIAO Pharmaceutical Factory, with 10 mL astragalus injection corresponding to 20 g raw material.METHODS: Animal model of anoxic-ischemic brain injury was established in model group and astragalus root group, but was not established in sham-operation group. In astragalus root group, immediately after establishing anoxic-ischemic model and at the same time point each day, 0.08 mL astragalus injection was administered intraperitoneally until the 7th postoperative day. In model group, 0.08 mL normal saline was administered at the same time points. In sham-operation group, no treatment was given. In astragalus root group and model group, animals were decollatedat 24 hours and 5 days postoperatively to take out the brains. In sham-operation group,animals were decollated and their brains were taken out at 24 hours postoperatively. In all the groups, hippocampal brain injury was detected using histopathological method combined with semi-quantified RT-PCR methods for detecting caspase-3 mRNA. Adult rats aged 90 days were used in modified y maze to examine their learning and memory functions. All these three experiments were independent.MAIN OUTCOME MEASURES:① Hippocampal brain injury in each group was evaluated using pathological method.② Caspase-3 mRNA in the ligated side of hippocampus was detected.③ Results of modified Y maze test were analyzed.RESULTS:All of the 114 rats entered the statistical analysis.① Assessment ofhippocampal brain injury in each group with pathological method:In sham-operation group, the bilateral hippocampus showed no swelling or necrosis, and neural cells in this area had normal morphological features with a density of (87.7±0.6) × 103 per high amplification field. In model group, the ligated side of hippocampus was swollen with a widened spatium and the cell density decreased to (68.8±3.0) × 103 per high amplification field, which significantly differed from that in sham-operation group (P ＜ 0.01). At the fifth day, the volume of ligated side of hippocampus reduced with pyramid layer disorganized and neural cells sparse at a density of (48.7±2.2) × 103 per high amplification field. These changes were significantly different from those of sham-operation group and the same side at 24 hours (P ＜ 0.01). At 24 hours the ligated side of hippocampus was less swollen in astragalus root group than in model group.At day 5, the whole hippocampus was observed. At these two time points,cell death rate in astragalus root group was significant lower than that in model group(P ＜ 0.01).②Caspase-3 mRNA in the ligated side of hippocampus in all the groups: In sham-operation group, the expression of caspase-3 was low, with an absorbency value of 0.220±0.009. In model group, after ischemia and anoxia its expression increased. At 6 hours, it was 11% higher than that in sham-operation group. In astragalus root group, mRNA level reached its peak, which was 260% higher than that in sham-operation group (P ＜ 0.01). The peak of mRNA continued, decreased after 48 hours and returned to baseline at 5 days and 7 days. The fluctuation of mRNA was similar between astragalus root group and model group,but the peak value at 24 hours and 48 hours in astragalus root group was 44％-46％ lower than that in model group (P ＜ 0.01). ③ Results of modified Y maze test: As compared to model group, in astragalus root group, the number of training times for meeting the standard made by the Association was significantly smaller [(45.7±2.7), (16.1±2.5) times, P ＜ 0.01] and at 24 hours after anoxia and ischemia, memory retention was significantly higher [(48.3±11.7), (80.0±9.0)%, P ＜ 0.01].CONCLUSION: Astragalus root can effectively inhibit the apoptosis of neural cells in hippocampus in immature brain after anoxia and ischemia and enhance the survival rate of them. This protective effect may be related to its inhibitory effect on the expression of caspase-3. Meanwhile, astragalus root can dramatically improve learning and memory function of the immature brain after anoxia and ischemia.
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AIM: To explore the expression of caspase -3 (cysteinyl aspartate-specific proteinase) in the neonatal rat cerebral cortex a nd hippocampal after hypoxia-ischemia. METHODS: Sham and hypoxia-ischemia (HI) groups were set up. The neonatal HI procedure was performed in 7-day-old rat pups. The double-lateral co rtex and hippocampal was subjected to pathological assessment, immunohistochemic al staining with caspase-3 antibody and half-quantitative reverse transcription and polymerization chain reaction (RT-PCR) to measure the change in caspase-3 pr otein and mRNA expression. RESULTS: Caspase-3 mRNA in ipsilateral cerebral cortex and hippo campal increased immediately after HI followed by a partial recovery. Thereafter caspase-3 mRNA and protein simultaneously increased with a maximum reached at 2 4-48 h after HI. CONCLUSION: Caspase-3 may play a key role in the development of apoptotic hypoxic-ischemic brain damage (HIBD) in immature rats. Neuroprotective medicine should be used before 24-48 h after HI.