妊娠早期女性非稳态负荷水平与抑郁的相关性研究

背景 已知慢性应激与抑郁发生相关,非稳态负荷（AL）作为评估机体慢性应激反应的综合生理指标可能在抑郁的发生过程中起着重要作用。目的 探讨妊娠早期女性AL水平与抑郁的关系。方法 采用便利抽样法,选取2021年11月—2022年6月于中国人民解放军联勤保障部队第901医院、六安市金安区妇幼保健院产检的630例妊娠早期女性为研究对象,根据有无抑郁分为抑郁组（n=162）和非抑郁组（n=468）。采用一般资料调查表、妊娠相关焦虑量表、爱丁堡产后抑郁量表进行问卷调查,通过体格检查和实验室检查收集AL相关数据。采用多因素Logistic回归模型分析妊娠早期女性AL与抑郁的相关性。结果 630例妊娠早期女性抑郁发生率为25.7%(162/630)。低水平AL(AL<3分)孕妇427例（67.8%）,高水平AL(AL≥3分)孕妇203例（32.2%）。多因素Logistic回归分析显示,高水平AL是妊娠早期女性抑郁的危险因素[OR=1.651,95%CI(1.096,2.489),P<0.05]。结论 妊娠早期女性AL与抑郁存在正向关联,高水平AL会增加抑郁的发生风险。     

Successful pregnancy in advanced renal failure without dialysis

We describe a successful pregnancy in a 22-year-old patient with advanced renal failure, who gave birth to a living boy in the 35th week of pregnancy. At the time of spontaneous delivery the mother had a serum creatinine of 851 mol/l. No dialysis treatment had been instituted during this successful pregnancy.     

妊高征患者红细胞免疫粘附调节因子活性的测定

目的 :通过测定妊高征 (PIH)患者红细胞免疫粘附 (RCIA)调节因子活性 ,探讨PIH患者红细胞免疫功能改变的原因。方法 :测定 40例PIH患者和 30例正常孕妇的RCIA促进因子活性和抑制因子活性及红细胞补体受体花环率(RBCC3bRR% )、红细胞免疫复合物花环率 (RBCICR % )。结果 :与正常孕妇相比 ,PIH患者RCIA抑制因子活性明显升高 ,RBCC3bRR%及RBCICR %明显降低 (P <0 .0 1) ,RCIA促进因子活性无明显变化 (P >0 .0 5 )。结论 :PIH患者红细胞免疫功能原发低下 ,其原因可能与RCIA抑制因子活性增高有关     

ACTH-producing cells of 21-day-old rat fetuses after maternal dexamethasone exposure

Adrenocorticotrophic hormone (ACTH) is essential for developmental maturation of numerous organ systems during the fetal period and for adaptation to environmental challenges. Immunocytochemical and stereological methods were used in the present study to examine the effects of dexamethasone (Dx) administration during pregnancy on fetal rat pituitary ACTH-producing cells. Doses of 0.5, 0.5 and 1.0 mg Dx/kg body weight/day were given to the dams on 3 consecutive days starting on day 16 of gestation. Morphometric analysis of the ACTH-producing cells of fetuses at 21 days of gestation revealed significant inhibition by 24% and 27%, respectively, of cell volume and cell number after maternal Dx administration, whereas the volume of cell nuclei and volume density of ACTH-stained cells were insignificantly decreased. Immunocytochemical analysis showed reduced numbers, sizes and immunopositivity of ACTH cells of 21-day-old fetuses from Dx-treated dams as compared with the control group. Maternal Dx treatment in the period of intense differentiation of the hypothalamo-hypophyseal-adrenal system had an inhibitory effect on fetal function and proliferative activity of ACTH-producing cells at 21 days of gestation. Thus, inhibition of activity of fetal ACTH-producing cells may lead to adrenal suppression, modified activity of the hypothalamo-pituitary-adrenal axis and reduced body weight possibly causing lasting functional abnormalities.     

产科多器官功能障碍综合征临床分析

目的探讨产科多器功能障碍综合征（MODS）的诱因、临床诊断及处理。方法对16例MODS的临床资料进行回顾性分析。结果导致MODS的主要因素为妊娠期高血压疾病及产后出血,器官功能障碍以肾功能衰竭为最多见。结论及时处理MODS的诱发因素,积极治疗妊娠期高血压疾病及产后出血,早期诊断及治疗肾功能衰竭及凝血功能障碍,是减少产科MODS患者死亡的关键。     

Postpartum copulation and induction of pregnancy in roof rats (Rattus rattus)

Two groups of 10 female roof rats were mated either in cycling or postpartum estrus to provide a quantitative comparison of copulatory behavior and to compare the stimulus requirements for the initiation of pregnancy. Animals in both estrous conditions were mated to one ejaculation, three ejaculations and to sexual satiety in repeated tests. The results indicate there were no differences between estrous conditions in the qualitative patterns of copulation but that males achieved more intromissions in the first series of postpartum tests than in cycling estrous tests. The stimulus requirements for pregnancy initiation were not found to vary as a function of estrous condition, however it was found that postpartum matings resulted in more pups per litter than did cycling estrous matings. The results were discussed with regard to the functional significance of species differences in copulatory behavior and in stimulus requirements for pregnancy.     

卵巢低反应者体外受精-胚胎移植的临床结局分析

目的评估首次体外受精-胚胎移植时表现为卵巢低反应的患者接受再次体外受精-胚胎移植治疗的实际意义和调整临床处理过程的价值。方法回顾性分析2004年1月至12月间在北京大学第三医院生殖中心进行体外受精-胚胎移植的206个卵巢低反应病例,共288个周期的临床资料。结果206例卵巢低反应病例首次IVF-ET时临床妊娠率为22%。其中82例接受了再次IVF-ET,临床妊娠率为40.6%,高于首次IVF-ET,经统计学检验差异有显著性(P<0.05),再次IVF-ET的E2峰值,取卵数以及移植胚胎数均高于首次IVF-ET,经统计学检验差异有显著性(P<0.05)。结论首次IVF-ET卵巢低反应的患者经过调整促排卵方案,接受再次IVF-ET时临床妊娠率有所提高。     

孕、产妇血清和胎儿脐带血血清骨钙素水平的动态变化

目的　为阐明孕妇和胎儿骨钙素 (osteoblastic)代谢规律 ,对各孕周期妇女外周血和胎儿脐带血骨钙素水平的动态变化进行研究。方法　采用荧光酶联免疫法对 14 2例孕妇、2 2例产妇及 34例不同孕龄胎儿的脐带血骨钙素水平进行检测。结果孕妇血清骨钙素随妊娠发展逐渐下降 ,至孕中期最低 (3.3± 1.4 6 ) μg/L ,随后又逐渐升高。分娩即刻产妇血清骨钙素 (12 .81± 4 .2 8) μg/L显著高于妊娠各阶段的水平 (P <0 .0 1) ,产后数日即显著下降至接近妊娠前的基线水平。脐带血骨钙素水平在孕中期最低 (0 .88± 0 .39) μg/L ,随后则升高 ,并且自孕 2 4w起保持于接近母体血清骨钙素水平。结论这段妊娠期是胎儿骨钙积累活跃的阶段 ,这种恒定的骨钙素水平对胎儿骨骼系统的正常发育 ,可能具有重要意义     

5992例孕产妇梅毒筛查与分析

目的 了解妊娠期梅毒的流行情况及对围产结局的影响。方法 对5992例孕产妇进行甲苯胺红不加热血清试验（TRUST）筛查，对TRUST阳性病例再进行梅毒螺旋体血清颗粒凝集试验（TPPA）确诊。并对围产结局进行观察分析。结果 5992例孕产妇，检出梅毒患者43例（0．72％），其中30例经青霉素治疗的患者其新产儿经半年以上随访无1例感染梅毒，在未治疗的13例患者中有10例分娩的新生儿TPPA滴度均≥1：40，其中2例为先天性梅毒。1例为死亡梅毒婴儿。结论 开展妊娠期梅毒血清学的产前筛查，加强对妊娠期梅毒的治疗，对减少先天性梅毒的发生尤为重要。     

体外受精-胚胎移植患者妊娠率与年龄及多精受精关系的研究

目的探讨体外受精-胚胎移植（IVF-ET）患者的妊娠率与年龄及多精受精的关系。方法收集1234个IVF-ET治疗周期,回顾分析不同年龄组的妊娠率及其与多精受精的关系。结果随着年龄的增长,患者IVF-ET周期的妊娠率和多精受精率均降低,并且同年龄组多精受精发生周期的妊娠率高于非多精受精组。结论女性的年龄与IVF-ET周期的妊娠率和多精受精的发生呈负相关,年龄与多精受精率都可作为预测IVF-ET结果的临床指标。