剖宫产再孕的妇女孕期B超监测下剖宫产瘢痕形态学改变

目的:通过B超监测评价剖宫产再孕的孕妇在整个妊娠过程中剖宫产瘢痕处的形态改变,并评价最后的分娩结局。方法:应用阴道超声观察320例有剖宫产史并再次妊娠的妇女怀孕11～13周、19～21周以及32～34周时剖宫产瘢痕的变化,主要测量剖宫产瘢痕处子宫肌层的厚度变化。结果:在320例孕妇中,284例发现剖宫产瘢痕的宽度、长度及厚度均发生改变,比例达到88.7%,瘢痕的长度和宽度明显增大,瘢痕的厚度明显变薄。2例孕妇因剖宫产瘢痕处子宫肌层发生破裂而终止妊娠,这2例病例,B超监测瘢痕处子宫肌层厚度为0.5mm,整个孕期减少了2.7mm、2.5mm。结论:通过观察,建立了相关的B超参考数据,并证明了剖宫产瘢痕在下一次妊娠中会发生形态学上的改变。菲薄的瘢痕处肌层厚度以及该处厚度的快速减少是剖宫产瘢痕破裂的先兆,在剖宫产再孕产妇的孕期监测过程中,瘢痕处肌层厚度的快速改变是提示剖宫产瘢痕破裂的潜在预警信号。这对防止剖宫产再孕的孕妇发生子宫破裂具有重要的意义。

Effects of Xinfeng capsule on pulmonary function based on treg-mediated notch pathway in a rat model of adjuvant arthritis

OBJECTIVE:To observe the impact of xinfeng xapsule(XFC) on pulmonary function in a rat model of adjuvant arthritis(AA) and to investigate the mechanism of action.METHODS:Forty rats were randomly divided into four groups of ten:normal control(NC);model control(MC);tripterygium glycosides tablet(TPT);and xinfeng capsule(XFC).Except for the NC group,AA was induced in all rats by intracutaneous injection of 0.1 mL Freund's complete adjuvant in the right paw on the 19th day.NC and MC groups were given(0.9%) physiological saline.The TPT and XFC groups were given TPT(10 mg/kg) and XFC(1.2 g/kg),respectively.Thirty days after administration,changes in paw edema(E),the arthritis index(AI),pulmonary function,levels of regulatory T-cells(Treg),ultrastructure of lung tissue,and expression of Notch receptors and ligands in lung tissue were observed.RESULTS:In the MC group,E and the AI were increased and pulmonary function significantly decreased;the structure of alveolar type-II cells was damaged;ratios of Treg in peripheral blood were reduced;and expression of Notch receptors such as Notch3 and Notch4 and ligands such as Delta1 in lung tissue were significantly increased whereas expression of Notch1,Jagged1 and Jagged2 were significantly decreased.After intervention with XFC,E and the AI were decreased;pulmonary function was enhanced;the structure of alveolar type-II cells was improved;and expression of Treg,Notch1,Jagged1,Jagged2 was elevated,whereas that of Notch3,Notch4 and Delta1 was reduced.CONCLUSION:XFC can not only inhibit E and the AI and improve joint symptoms,it can also improve pulmonary function and reduce inflammation in lung tissue.These actions could be carried out through increases in the expression of Treg,Notch receptors(Notch1) and ligands(Jagged1,Jagged2),and reductions in the expression of Notch3,Notch4 and Delta1.These phenomena would reduce the deposition of immune complexes and the inflammatory response in lung tissue,thereby improving joint symptoms and pulmonary function.

Use of Xinfeng capsule to treat abarticular pathologic changes in patients with rheumatoid arthritis

OBJECTIVE: To observe the influence of Xinfengcapsule(XFC) on abarticular pathologic changes(APCs) and other indices of patients with rheumatoid arthritis(RA) and explore the mechanism of action of XFC in improving such changes.METHODS: Three-hundred RA patients were divided randomly into a treatment group(n=150) and control group(n=150). A normal control(NC)group(n=90) was also created. Changes in cardiac function, pulmonary function, anemia indices and platelet parameters of RA patients were measured.Curative effects of the two groups were compared,and comparison carried out with the NC group.RESULTS: In 300 RA patients, late diastolic peak flow velocity(A peak) was much higher(P<0.01)and early diastolic peak flow velocity(E peak), E/A,and left ventricular fraction shortening much lower(P<0.01) than those in the NC group. Vital capacity(VC), forced vital capacity in one second, forced vital capacity(FVC), maximal voluntary ventilation(MVV), maximal expiratory flow in 50% of VC(FEF50) and FEF75 were lowered remarkably(P<0.05 or P<0.01). Platelet count(PLT), plateletcrit(PCT) and mean platelet volume(MPV) increased markedly(P<0.05 or P<0.01), and hemoglobin(Hb)level decreased significantly(P<0.05). After XFC treatment, the A peak and PLT and PCT were much lower(P<0.05), and E/A and the number of red blood cells as well as Hb level were much higher(P<0.05), as were FVC, MVV and FEF50(P<0.05 or P<0.01), in the treatment group than those in the NC group. Total score of pain and swelling in joints,uric-acid level and high-sensitivity C-reactive protein level were much lower, and superoxide dismutase level as well as the number of CD4 +CD25+ regulation T cells(Treg) and CD4+CD25+CD127- Treg were much higher(P<0.05 or P<0.01)in the treatment group than those in the NC group.CONCLUSION: RA patients with pathologic changes in joints also suffer from lower cardiac and pulmonary functions and from parameters of anemia and platelet factors. XFC can improve the symptoms of RA patients, ameliorate their cardiac and pulmonary functions and reduce the parameters of anemia and platelet factors. XFC lowers the immune inflammatory reaction to improve APCs in RA patients.

Effect of age on the pharmacokinetics of polymorphic nimodipine in rats after oral administration

The previous investigation has proved that their existed pharmacokinetic difference between the different crystal forms of the polymorphic drugs after oral administration.However,no systemic investigations have been made on the change of this pharmacokinetic difference,resulted either from the physiological or from the pathological factors.In this paper,we used polymorphic nimodipine(Nim) as a model drug and investigated the effect of age difference(2- and 9-month old) on the pharmacokinetics after oral delivery in rats.As the results shown,for L-form of Nim(L-Nim),the AUC0–24 hin 2-month-old rats was 343.68747.15 ng h/m L,which is 23.36% higher than that in 9-month-old rats.For H-form of Nim(H-Nim),the AUC0–24 hin 2-monthold rats was 140.91719.47 ng h/m L,which is 54.64% higher than that in 9-month-old rats.The AUC0–24 h ratio between H-Nim and L-Nim was 2.44 in 2-month-old rats and 3.06 in 9-month-old rats.Since age difference could result in unparallelled change of the absorption and bioavailability of the polymorphic drugs,the results in this experiment are of value for further investigation of crystal form selection in clinical trials and rational clinical application of the polymorphic drugs.