不同类型妊娠高血压疾病的妊娠结局分析

目的分析不同类型妊娠高血压疾病产妇的妊娠结局。方法回顾性分析我科收治的257例妊娠高血压疾病产妇的病历资料,根据疾病类型分为妊娠期高血压组(A组,163例)、轻度子痫前期组(B组,47例)、重度子痫前期组(C组,32例)、子痫组(D组,15例)。分析四组产妇的妊娠结局。结果四组产妇合并妊娠期糖尿病、早产、产后出血的并发症发生率分别都有差异,且差异具有显著性统计学意义(P<0.05);而剖宫产率并无统计学差异(P=0.286)。四组的新生儿窒息、胎儿窘迫、死胎的发生率分别都有差异,且差异具有显著性统计学意义(P<0.05)。结论妊娠高血压疾病严重危害产妇及新生儿健康,且不同类型妊娠高血压疾病对产妇妊娠并发症及新生儿预后有着很大影响。     

瘢痕子宫合并妊娠高血压疾病对母婴结局的影响

目的观察瘢痕子宫合并妊娠高血压疾病对母婴结局的影响。方法回顾性分析108例妊娠高血压疾病产妇的临床资料,其中将50例有剖宫产史的产妇设为观察组,将58例无子宫手术史的产妇设为对照组,观察两组产妇妊娠并发症情况及母婴结局。结果两组产妇妊娠并发症(胎盘早剥、胎盘前置、DIC、妊娠高血压性心脏病、HEILP综合征)发生率比较,均无统计学差异(P0.05);观察组早产、产后出血、剖宫产、子宫破裂、子宫切除发生率及新生儿窒息、围生儿死亡发生率均明显高于对照组(P0.01或P0.05)。结论瘢痕子宫合并妊娠高血压疾病产妇妊娠期及母婴结局均存在较大的风险,因此对该特殊群体产妇应加强围产期监护,积极采取医学干预手段,尽可能改善预后,确保母婴安全。     

双胎与减胎后双胎妊娠结局比较分析

目的分析体外受精-胚胎移植术后多胎妊娠行减胎术对妊娠结局的影响,以及减胎后双胎妊娠与未减胎双胎妊娠患者妊娠结局比较,评价其安全性。方法回顾性分析125例多胎妊娠减胎患者,统计其早期流产率,晚期流产率,低体重婴儿出生率,早产率以及平均出生孕周,并与同期IVF-ET治疗未行减胎术的双胎1830例患者比较。结果减胎组早期流产率1.6%,晚期流产率10.4%,双胎未减胎组早期流产率1.9%,晚期流产率5.4%,两组间晚期流产率差异有统计学意义。减胎组及三胎减为双胎组的早产率与低体重儿出生率稍高于双胎未减胎组。结论在B超引导妊娠早期选择性减胎术是安全有效的,可以降低多胎妊娠的并发症。     

甲状腺激素水平对高龄产妇妊娠结局的影响

目的探讨不同妊娠周期的高龄产妇甲状腺激素水平对妊娠结局的影响。方法收集我院收治的136例高龄产妇的临床资料,根据产妇促甲状腺激素(TSH)水平分为对照组62例,甲亢组39例,甲减组35例。3组产妇均在妊娠早期、中期和晚期抽取静脉血进行血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)以及血清IgA、IgG和IgM水平的检测,并对比3组产妇妊娠结局。结果甲亢组产妇在妊娠早期、中期和晚期的TSH水平明显低于对照组和甲减组(P<0.05),FT3和FT4水平明显高于对照组和甲减组(P<0.05);妊娠早期、中期和晚期,甲减组产妇TSH水平和对照组比较明显较高,FT3和FT4水平和对照组比较明显较低,差异有统计学意义(P<0.05)。甲亢组产妇在妊娠早期、中期和晚期的IgA、IgG、IgM水平明显高于对照组和甲减组(P<0.05);妊娠早期、中期和晚期,甲减组产妇IgA、IgG、IgM水平和对照组比较明显较低(P<0.05)。甲亢组、甲减组健康足月新生儿率和对照组比较明显较低,剖宫产率和对照组比较明显较高,差异有统计学意义(P<0.05)。结论甲状腺激素水平异常影响高龄产妇免疫功能和妊娠结局,应对妊娠期高龄产妇的甲状腺激素水平加强检测和处理,以提高产妇生育质量,促进产妇和婴儿身体健康。     

胚胎移植术后14 d血清β-HCG对妊娠结局的预测

目的：探讨试管婴儿胚胎移植术后14 d血清人绒毛膜促性腺激素(β-HCG)值对妊娠结局的预测作用。方法回顾性分析本中心2013年6~12月新鲜胚胎移植的275例临床妊娠患者,其中常规体外受精-胚胎移植192例,卵胞质内单精子注射83例。检测胚胎移植后14 d血清β-HCG值。妊娠分为单胎妊娠、双胎妊娠和三胎妊娠。妊娠结局分为异位妊娠、流产、早产、足月。结果单胎妊娠与双胎妊娠、三胎妊娠之间的β-HCG值差异有统计学意义(P=0.000)。早产组与异位妊娠组、流产组、足月产组之间的β-HCG值差异有统计学意义(P=0.014、0.000、0.002)。三胎妊娠中,足月产与早产的β-HCG值差异有统计学意义(t=3.552,P=0.005);早产组中,单胎妊娠与双胎妊娠的β-HCG值差异有统计学意义(P=0.004);足月产组中,单胎妊娠与双胎妊娠、三胎妊娠的β-HCG值差异有统计学意义(P=0.000)。结论胚胎移植术后14 d血清β-HCG值的高低可以在某种程度上预示胎儿数,但是并不能比较有效地预测妊娠的结局。     

体外受精-胚胎移植（IVF-ET）术后早期流产患者的相关因素分析

目的：探讨体外受精-胚胎移植( IVF-ET)术后早期流产患者的相关因素分析。方法选择2013年1月—2015年6月广西妇幼保健院生殖中心首次实施常规体外受精和卵母细胞内单精子显微注射后行新鲜胚胎移植获得妊娠的孕妇236例,根据妊娠后的结局不同进行分组,其中自然流产组42例,继续妊娠组194例。观察两组孕妇的年龄、不孕年限、基础内分泌、促性腺激素( Gn)使用天数、Gn使用总量、获卵个数、受精方式、子宫内膜厚度等指标,分析影响早期流产的因素。结果实施辅助生殖技术助孕早期流产发生率为12.50%。两组不孕年限、自然流产数、人工流产数、BMI、取卵日子宫内膜厚度、窦卵泡数、优胚数、胚胎移植( ET)数、Gn使用天数比较,差异无统计学意义(P>0．05),年龄、卵泡生成激素/黄体生成激素(FSH/LH)比值、获卵泡数、Gn使用量差异有统计学意义(P<0．05)。多因素回归分析结果显示孕妇年龄和FSH/LH比值为IVF-ET术后早期流产的危险因素。结论导致IVF-ET术后早期自然流产有多方面原因,尤其与年龄、激素水平有关。针对不同年龄患者,需制订个体化治疗方案,密切监测妊娠后激素水平等,以降低早期自然流产的发生率。     

288例早产相关因素临床观察

目的 探讨引起早产相关因素.方法 选择我院早产产妇共288例,本组早产患者中,经产妇共82例,初产妇共206例.其中医源性早产共78例,自然早产共210例.分析自然早产和医源性早产产妇中人流史、胎儿畸形、胎膜早破、双胎、臀位、妊娠高血压疾病、前置胎盘、其他不明原因等情况.结果 在本组早产产妇中,医源性早产78例,占27.1%(78/288);胎膜早破共102例,占35.4%(102/288);双胎妊娠共48例,占18.6%(48/288).结论 导致早产的前三位因素主要是胎膜早破、医源性早产和双胎妊娠,在妊娠期要加强产前保健,积极预防胎膜早破,控制感染.在孕前要减少人流次数,有助于减少早产发生.     

I VF-ET过程中流产因素分析

摘要 目的：探讨在IVF-ET过程中引起患者流产的因素,从而更好的提高临床妊娠率,减少和预防流产的发生。方法：选择2005年1月1日-2009年12月31日在行IVF-ET患者共3117例,临床妊娠患者1195例,其中流产患者203例,包括早期流产患者150例,为早期流产组,晚期流产患者53例,为晚期流产组。分别对两组患者年龄、体重指数(BMI)、COH情况以及妊娠情况进行分析,寻找导致IVF-ET治疗过程中患者临产的相关因素。结果：本中心IVF临床妊娠率为38.3%,流产率为16.9%,其中早期流产率为12.6%,晚期流产率为4.4%。早期流产组患者ET后14天血. β-hCG水平较低,晚期流产患者BMI较高、减胎及双胎妊娠率高。结论：早期流产多与胚胎本身发育异常有关,ET后14天血hCG水平偏低提示有胚胎发育差、早期流产的风险高的可能。另外高BMI以及应用大剂量Gn超排卵有可能影响子宫内膜的容受性,影响胚胎着床。而多胎妊娠和减胎术容易导致胎膜早破,可能是造成晚期流产的一个重要因素,另外胎儿畸形行引产术也是导致晚期流产的另一个重要因素。     

早产合并胎膜早破妊娠结局的临床观察

目的探讨早产合并胎膜早破妊娠结局的临床方法及效果。方法对2013年1月至2014年1月我院收治的62例早产合并胎膜早破产妇的妊娠结局进行回顾性分析。结果分析62例胎膜早破的母儿情况发现,感染22.58%(14/62)、流产引产史17.74%(11/62)以及胎位不正14.52%(9/62)等是诱发胎膜早破的主要因素;另外A、B、C三组围生儿并发症的发生率分别为87.50%(21/24)、60.00%(12/20)、38.89%(7/18),3组相比差异有统计学意义(P<0.05)。结论做好产妇的孕检以及指导工作,可以减少早产合并胎膜早破发生的可能性,医师可以根据产妇的具体情况做好预防工作降低产妇和孩子出现并发症的情况。     

晚期妊娠合并子宫肌瘤妊娠结局分析

目的探讨晚期妊娠合并子宫肌瘤对妊娠结局的影响。方法回顾性分析302例妊娠合并子宫肌瘤患者(肌瘤组)的临床资料,以同期妊娠无子宫肌瘤孕妇283例作为对照组,对其妊娠期并发症、分娩期并发症、分娩方式、手术中处理及新生儿结局进行比较。结果妊娠合并大于5 cm肌壁间子宫肌瘤患者发生早产、胎位异常、前置胎盘、胎儿窘迫、产后出血及低体重儿的风险大于对照组(P<0.01)。剖宫产术中行浆膜下及小型肌壁间肌瘤剔除并不增加术中出血风险(P<0.01)。术中剔除的肌瘤组织常规送病检,变性120例,变性率为71.4%。结论大于5 cm的肌壁间肌瘤增加产科并发症的风险。孕期肌瘤变性率高。浆膜下及小型肌壁间肌瘤剖宫产术中行肌瘤剔除术是安全可行的。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.