缩宫素脐静脉注射治疗胎盘粘连63例临床观察

目的观察脐静脉注射缩宫素治疗胎盘粘连的临床疗效。方法对剖宫产术中胎盘粘连产妇采用缩宫素脐静脉注射（观察组）与缩宫素子宫肌层注射（对照组）的疗效比较。结果63例观察组中自然剥离胎盘者52例,11例采取了人工剥离胎盘术;65例对照组中人工剥离胎盘者43例,22例自然剥离,两组比较P〈0．05,有显著差异。在产后2h出血量方面,观察组215±36．6ml,对照组383±58．2ml,两组比较P〈0．05,有显著差异,有统计学意义。结论脐静脉注射缩宫素治疗胎盘粘连,减少了人工剥离胎盘的几率,减少产后出血量,此方法简便,安全,取得了良好的效果。     

剖宫产术前补钙防治宫缩乏力性产后出血的临床观察

目的观察剖宫产前补钙对产后出血的影响,分析血钙含量与产后出血量是否有内在联系。方法选择剖宫产产妇108例,术前随机等分为补钙组和对照组各59例．补钙组术前15—30min内静脉注射50％葡萄糖注射液40ml加10％葡萄糖酸钙注射液10ml;对照组术前不用药。结果产后出血量补钙纽亦明显低于对照组,差异有显著性（P〈0．05）结论剖宫产术前补钙对防治产后宫缩乏力,减少产后出血,使用方便、简单、经济安全,值得临床推广使用。     

益母草注射液联合格丹及欣母沛在前置胎盘剖宫产 术后出血中的应用及安全性分析

目的 分析益母草注射液联合格丹及欣母沛在前置胎盘剖宫产术后出血中的应用效果及安全性。方法 选取我院因前置胎盘行剖宫产术的60例产妇,随机分为两组各30例。对照组采用益母草注射液联合欣母沛,观察组在对照组基础上加用格丹,观察两组止血显效率、术后不良反应、出血情况、术后并发症发生率、子宫复旧率、术后Hb、RB水平以及新生儿结局。结果 两组止血显效率、术后不良反应和新生儿结局相比,差异无统计学意义（P＞0.05）。观察组术中、术后出血情况以及并发症发生率均低于对照组,子宫复旧率和术后Hb、RBC均高于对照组,差异具有统计学意义（P＜0.05）。结论 益母草注射液联合格丹及欣母沛治疗前置胎盘剖宫产术后出血效果确切,可减少术后并发症,且无严重不良反应,术后产妇恢复良好。     

剖宫产产后大出血临床救治51例

目的观察剖宫产产后大出血临床救治的方法及效果。方法选取本院剖宫产产后大出血的患者51例,将其随即分为治疗组和对照组,治疗组25例,对照组26例,治疗组采用宫腔填塞纱条法,并给予静脉注射缩宫素及舌下含服卡孕栓治疗;对照组给予静脉注射缩宫素及舌下含服卡孕栓,经治疗后比较两组的治疗效果。结果经救治,两组患者均脱离生命危险,治疗组的有效率为100%,对照组的有效率为96.1%,治疗组产妇的出血量明显小于对照组,且手术时间短于对照组。结论宫腔填塞纱条法合并促子宫收缩药物治疗剖宫产产后大出血的治疗方法取得了较好的临床效果,能够及时止血,有效避免出现其他并发症。     

子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中 胎盘剥离面出血的临床研究

目的 研究子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血的临床效果。方法 回顾分析2017年1月~12月在我院治疗的70例前置胎盘剖宫产术中胎盘剥离面出血患者,将其随机分为对照组和观察组,每组35例。对照组采用传统的“8”字缝合方法止血,观察组采用子宫下段横形环状压迫缝合术止血,观察对比两组术中出血量、术后出血量、欣母沛使用量、缩宫素使用量和并发症发生率。结果 观察组术中出血量、术后出血量、欣母沛使用量少于对照组,差异有统计学意义（P＜0.05）;两组缩宫素使用量、并发症发生率相比,差异均无统计学意义（P＞0.05）。结论 子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血安全有效,值得临床推广和应用。     

葡萄糖酸钙与米索前列醇在剖宫产中的应用

目的 观察有产后出血高危因素的剖宫产,术前补钙术后肛门置米索前列醇,防治宫缩乏力性产后出血的效果.方法 选择我院有产后出血高危因素的剖宫产病例100例术前补钙术后肛门置米索前列醇作为观察组,同时选100例单用缩宫素的作为对照组.两组年龄、孕周、高危因素经统计学处理无统计学意义.观察组于手术开始同时10%葡萄糖10 ml+10%葡萄糖酸钙10ml缓慢静脉注射,胎儿娩出后宫体注射缩宫素20u,术后肛门置米索前列醇600ug:对照组胎儿娩出后宫体注射缩宫素20u,分别观察两组术中出血量、术后阴道出血量、术后24小时的总出血量、以及产后出血的发生率.结果 观察组术中出血量、术后阴道出血量、以及术后24小时的总出血量均明显少于对照组(P＜0.05),产后出血的发生率明显少于对照组(P＜0.05)有统计学意义.结论 存在产后出血高危因素的剖宫产,术前补钙术后肛门置米索前列醇,可以很好地预防和降低产后出血的发生率.     

改良Cho缝合术在前置胎盘剖宫产术中的临床观察

目的观察改良Cho缝合术在前置胎盘孕妇剖宫产术中的临床应用效果。方法观察组62例前置胎盘孕妇在剖宫产术中采用改良Cho缝合术,对照组随机抽取2010后以前采用局部“8”字缝合开放血窦及宫腔纱条填塞压迫法的前置胎盘孕妇62例。结果62例观察组中,平均手术时间85±22．35min,术中出血量815．37±279．34ml,34例输血,占54．84％,输血量800±400ml,无一例切除子宫。而62例对照组中平均手术时间115±25．51min,术中出血量1456±317．19ml,53例输血,占85．48％,输血量1200±600ml,3例中央性前置胎盘产妇行子宫切除术。两组有统计学意义,P〈O．01。结论对于前置胎盘的孕妇在剖宫产术中发生子宫下段胎盘附着处出血,采用改良Cho缝合术,大大减少了产妇的出血量,减少了输血的机率及输血量,缩短了手术时间,此方法安全简便,经济有效。     

米索前列醇直肠给药对产后出血的预防效果

目的观察米索前列醇直肠给药对产后出血的预防效果。方法选取在我院住院分娩产妇180例，按照数字随机法将分娩产妇分成三组，A组：缩宫素组。 B组：米索前列醇组。 C组：对照组。 A组于胎儿娩出后静脉推注生理盐水20ml加缩宫素10μ，继而缩宫素10μ加入生理盐水500ml静脉滴注。 B组于胎儿娩出后采取米索前列醇400μg直肠给药。 C组：于胎儿娩出后静脉滴注生理盐水500ml。比较三组预防产后出血的效果。结果对照组C组产后出血发病率5%，A组产后出血发病率1.6%，B组产后出血发病率0豫。观察组A.B两组产后出血发病率均低于对照组，差异有统计学意义(P<0.05)。观察组A.B两组第三产程时间短于对照组，差异有统计学意义(P<0.05)。观察组A.B两组产后2h出血量少于对照组，差异有统计学意义(P<0.05)。结论米索前列醇直肠给药可以有效预防产后出血的发生，缩短第三产程时间，减少产后2h出血量。     

凶险性前置胎盘23例临床分析

目的：探讨凶险性前置胎盘对孕产妇的危害性,提高对凶险性前置胎盘的认识。方法：2003年1月～2012年2月我科收治凶险眭前置胎盘孕妇23例为观察组,既往剖宫产（1．7±0．4）次;选择同期收治的非凶险性前置胎盘孕妇57例为对照组,既往剖宫产（1．4±0．2）次。对两组患者的临床资料进行对比分析。结果：观察组23例,胎盘粘连、植入14例（60．87％）;剖宫产术中产后出血20例（86．96％）,出血量（2785±263）ml;全子宫切除术14例（60．87％）,其中死亡1例（4．35％）。对照组57例,胎盘粘连、植入3例（5．26％）;剖宫产术中产后出血19例（33．33％）,出血量（850±340）ml;全子宫切除术3例（5．26％）;无一例死亡。观察组既往剖宫产次数、手术时间、胎盘粘连植入的发生率、产后出血量及子宫切除率均高于对照组,差异具有统计学意义（P〈0．05）。45例患者获随访,随访时间1～6个月,平均5个月。随访期间仅1例全子宫切除患者于术后半个月出现阴道残端少量流血,予止血治疗后痊愈,其余患者均恢复良好。结论：凶险性前置胎盘对孕产妇危害严重,减少剖宫产次数可降低凶险性前置胎盘的发生率。提高对凶险性前置胎盘危害的认识,选择正确的围手术期处理方法是保证孕产妇生命安全的关键。     

米非司酮配伍米索前列醇及地西泮注射液的临床疗效

目的观察米非司酮配伍米索前列醇及地西泮注射液终止14～20w有剖宫产史中期妊娠的临床疗效。方法对100例孕14～20w有剖宫产史的妇女,（前次剖宫产手术距离本次妊娠2.5~12年不等）,随机分为米非司酮配伍米索前列醇口服(治疗组),米非司酮口服配伍米索前列醇及地西泮注射液20 mg用于子宫后穹隆(对照组)各50例,观察两组孕妇的临床体征及效果。结果两组比较明显说明治疗组临床疗效低于对照组(P<0.05)。结论通过临床实践,米非司酮配伍米索前列醇终止14～20w妊娠,米索前列醇联合地西泮用于子宫后穹隆的临床效果比口服米索前列醇效果好、流产成功率高、胎盘残留率低、总产程短、出血量较少、副反应小,安全性高。     

James Jeffray: Observations on the heart and on the peculiarities of the foetus

James Jeffray, Regius Professor of Anatomy in the University of Glasgow (1790–1848), published his lectures on the heart as a monograph entitled Observations on the Heart and on the Peculiarities of the Foetus (Jeffray, 1835), in which he considered controversies about the adult heart, such as the arrangement of the coronary vessels and the function of the aortic and pulmonary sinuses, and about the fetal circulation. His sources were the works of Senac, Lower, Vieussens, Eustachius, Mery, Haller, Winslow, and Sabatier which were available from the Hunterian bequest. Jeffray supplemented his own material with Hunterian specimens for the illustrations. He supported the theory that blood from the superior and inferior venae cavae crossed in the right atrium, that from the superior cava being destined for the right ventricle and from the inferior passing through the foramen ovale to the left atrium. He also held that the valve of the inferior vena cava directed the bloodflow from that vessel to the foramen ovale. These views conflicted with those of John Bell (1763–1820), a successful Edinburgh anatomist and surgeon whose opinions are attacked several times in the publication. Regarding the placenta, Jeffray may have been deliberately vague about whether the fetal and maternal circulations are continuous or separate, an issue resolved by William Hunter in the previous century. Clin. Anat. 12:35–42, 1999. © 1999 Wiley‐Liss, Inc.     

Study on the interference of ticlopidine on the immune system

In-vitro and ex-vivo studies have been performed in order to investigate the possible interference of ticlopidine on different lymphocyte parameters. In vitro, ticlopidine displays a dose-dependent inhibition of both spontaneous and lectin-induced 3H-thymidine incorporation by normal lymphocytes. Moreover the highest drug concentrations also reduce the in-vitro PWM-stimulated Ig synthesis. Lymphocyte tests performed in healthy volunteers after a 10-day oral treatment (250 mg/day) show only a slight reduction of PHA- and ConA-induced proliferative responses and in-vitro PWM-stimulated Ig synthesis. The values found after treatment however remain within the normal range, excluding a clear interference of ticlopidine on the immune parameters tested. In addition the treatment does not affect the white blood cells nor the lymphocyte subset distribution identified by the monoclonal antibodies OKT3, OKT4 and OKT8.     

Reflections on the mechanical structure of the base of the skull and on the face

Using thick sections of the base of the skull and face their mechanical structure is viewed from the engineering aspect and the anatomic solutions evolved are compared with those selected by Aerospatiale engineers for the concept and development of the Airbus. It is concluded that the anterior and middle cranial fossae, together with the face, constitute an inseparable mechanical assembly each of whose component units participate in the rigidity of the others. Since this mechanical assembly must provide maximal rigidity for minimal weight, this suggests that aeronautical solutions should throw much light on the detail of construction of the skull and face. Indeed, the rigidity and lightness of the latter are obtained by means of solutions familiar in aeronautics: the reliance on thin-shelled beams with a honeycomb filling, the diploe analogous to a preconstrained composite or sandwich structure, a system of frames, struts and stiffeners, and the use of fillets at the sites of junction of struts.     

超声造影方法的再探讨

目的探讨造影剂（Sono Vue）和与之相匹配的对比脉冲系列成像技术（CPS）在超声造影（contrast—enhanced uhrasonography）中的方法。方法对不同的造影部位及不同造影目的采用了不同的造影参数设置。结果84例患者除1例注射时刺破血管造成造影剂外渗影响造影效果外，其余83例效果满意。超声造影检查对肿块定性诊断的准确率优于CT、MRI，心肌灌注检查为临床提供方便、可靠的无创方法。结论应根据使用的造影剂和成像技术及造影目的设置相应的造影参数。     

Studies on the influence of the structural modifications in the tracer on the immunoassay of progesterone

The main objective of the present study was to examine the influence of different bridges in radioiodinated tracers on the assay performance of progesterone using antibodies. Three homologous and two heterologous immunoassay systems for the measurement of progesterone in human serum are described. Using an antiserum raised against progesterone-11alpha-hemisuccinate-bovine serum albumin (BSA), assays with homologous radioligands, namely progesterone-11alpha-hemisuccinate-125I-tyrosine methyl ester (TME) and progesterone-11alpha-hemisuccinate-125I-histamine, heterologous bridge radioligand, namely progesterone-11alpha-hemiphthalate-125I-TME, and a heterologous site radioligand namely progesterone-3-(O-carboxymethyl) oxime (CMO)-125I-histamine were optimized. A homologous assay system, using antiserum raised against progesterone-3-carboxymethyl oxime-BSA and progesterone-3-CMO-125I-histamine as the radioligand was also optimized to develop a radio-immunoassay (RIA) for serum progesterone. Amongst the two homologous radioligands, viz., progesterone-11alpha-hemisuccinate-125I-histamine and the corresponding TME conjugate tracer, the former yielded a standard curve with a higher slope (-0.6) as compared to the latter (-0.5). The heterologous bridge system with progesterone-11alpha-hemiphthalate-125I-TME resulted in a more sensitive assay (slope of -0.8) than the homologous tracers, whilst the heterologous site radioligand, viz., progesterone-3-CMO-125I-histamine gave the most sensitive assay (slope of -1.2). The homologous assay with antiserum against progesterone-3-CMO-BSA and progesterone-3-CMO-125I-histamine tracer gave a standard curve having a slope of -0.97. The two antibodies developed against progesterone, viz., progesterone-11alpha-hemisuccinate-BSA and progesterone-3-CMO-BSA were characterized for their titre, sensitivity, and specificity. Considering the slope, sensitivity, cross-reactivity, and the quality of tracer, the assay system using antiserum against progesterone-11alpha-hemisuccinate-BSA and progesterone-3-CMO-125I-histamine was found to be suitable for the development of RIA for serum progesterone. The bridges used in an immunogen for production of antibodies, as well as in the preparation of tracer, have a great influence on the assay characteristics.