Can the process indicators for emergency obstetric care assess the progress of maternal mortality reduction programs? An examination of UNFPA Projects 2000-2004.

BACKGROUND: In view of the disappointing progress made in the last 20 years in reducing maternal mortality in low-income countries and before going to scale in implementing the new evidence-based strategies, it is crucial to review and assess the progress made in pilot countries where maternal mortality reduction programs focused on emergency obstetric care. OBJECTIVE: To review the process indicators recommended for monitoring emergency obstetric care and their application in field situations, examining the conditions under which they can be used to assess the progress of maternal mortality reduction programs. METHODS: Five of the six UN recommended process indicators were monitored annually for 5 years in selected districts of Morocco, Mozambique, India and Nicaragua. Trends are presented and discussed. RESULTS: With specific variations due to different local situations in the four countries and in spite of variations in quality of data collection, all indicators showed a consistent positive trend, in response to the inputs of the programs. CONCLUSIONS: The UN process indicators for emergency obstetric care should continue to be promoted, but with two important conditions: (1) data collection is carefully checked for quality and coverage; (2) efforts are made to match process and outcome indicators (maternal and perinatal mortality, incidence of complications).     

妇幼卫生专业毕业生的追踪调查

20 0 2年 9～ 1 2月对中山大学公共卫生学院妇幼卫生专业的毕业生及用人单位进行了信函追踪调查。结果表明 :总体而言 ,该系学生思想素质、业务水平、工作能力均较强 ,受到用人单位的一致好评。该系学生保健服务能力是强项 ,体现了“以保健为中心”的办学思想。但同时也发现妇幼系的培养模式、课程设置、教学方法均存在一定问题 ,最突出的是临床动手能力较差 ,其次为社区工作能力、组织管理能力、社交能力相对不足 ,创新能力较差 ,所以教学改革势在必行     

公立医院改革中两权分离理论和实践探索

研究公立医院改革中两权分离理论,探索实践意义.以国内外类似模式作借鉴分析,认为两权分离、国有民营是一种有益尝试,其引入了公司经营理念,又不改变公立医院的职能,两权关系明确,完善治理结构,提高核心竞争力.同时讨论了一些存在的问题和矛盾.     

The effects of maternal inflammation on neuronal development: possible mechanisms

That maternal inflammation adversely affects fetal brain development is well established. Less well understood are the mechanisms that account for neurodevelopmental disorders arising from maternal inflammation. This review seeks to begin an examination of possible sites and mechanisms of action whereby inflammatory cytokines - produced by the mother or by the fetal brain - could impact the developing fetus. We focus first on the placenta where cytokines maintain the immunological environment that prevents maternal rejection of the fetus. Following a brief examination of placental transfer of maternal cytokines, the focus turns on embryonic microglia, early and ubiquitous residents of the developing brain. Finally, a more intense examination of interleukin-6 (IL-6) and bone morphogenetic proteins (BMPs) provides examples of glial- or maternal-derived cytokines that are known to have profound effects on developing systems and that could, if dysregulated, have undesirable consequences for brain development.     

大鼠骨髓巨噬细胞的分离,纯化,培养以及鉴定

目的：为深入研究骨髓巨噬细胞的生物学功能，探索一种简便的骨髓巨噬细胞的分离，纯化和培养的方法。方法：分离获取大鼠骨髓细胞，在60％DMEM培养液，20％马血清，20％(v／v)L929培养上清的诱导条件下进行体外贴壁培养，6～7天时获得纯度较高的贴壁细胞。采用倒置显微镜下观察生活状态、Wrights染色光镜观察、电子显微镜观察检测贴壁细胞形态学；酸性磷酸酶及非特异性酯酶染色测定细胞内酶的表达；吞噬鸡红细胞及墨汁颗粒实验检测其吞噬功能；免疫细胞化学染色观察细胞表面标志等生物学技术鉴定培养的贴壁细胞性质。结果：获得高纯度的巨噬细胞，且具有良好的吞噬功能，并且具备巨噬细胞的形态特征，特有的水解酶类及特有的表面标志-CD68。结论：本法是一种简易实用的体外分离、纯化、培养骨髓巨噬细胞的方法。     

母亲苯丙酮尿症后代的脑MRI表现

目的 提高对母亲苯丙酮尿症(MPKU)后代脑MRI表现的认识。资料与方法 报告2例生化及临床检查证实为MPKU双胞胎的．MRI改变，并复习文献。结果 文中2例表现与文献报道不一致．与苯丙酮尿症患儿的表现相似。常规T2WI及FLAIR均显示室周白质、侧脑室三角区、半卵圆中心条片状高信号。弥散加权成像(DWI)除更清楚地显示上述改变外，尚显示双侧内囊后肢及胼胝体压部信号增高。结论 常规T2WI及FIJAIR上可显示MPKU后代脑白质异常，DWI可提供更多诊断依据。     

中药大蜜丸中活螨快速分离方法

本文对极易污染活螨的中药大蜜丸,在应用分离法的基础上,根据螨怕光、怕热的习性,适当调整光照,周围严格避光,达到分离活螨的目的.     

血清睾酮与妊高征发病相关性研究

目的:测定妊高征患者血清睾酮水平并探讨其临床意义。方法:采用放射免疫分析法测定妊高征患者30例、正常孕妇20例血清及其新生儿脐血睾酮水平。结果:妊高征患者血清睾酮水平(0.153±0.078nmol/L)明显高于正常孕妇组(0.023±0.015nmol/L),有显著性差异(P<0.001)。妊高征组脐血睾酮水平(0.052±0.041nmol/L)低于正常孕妇组(0.119±0.059nmol/L),有显著性差异(P<0.05),两组睾酮水平与新生儿性别无关(P>0.05)。结论:孕妇血清睾酮在妊高征的病理生理中起调节或加强作用。     

Separation discrimination with embedded targets

Previous research has shown that separation discrimination thresholds are independent of the internal spatial scale (local spatial frequency) of the targets whose separation is being judged. The experiments reported here tested the generality of this conclusion for separation discrimination of targets that were embedded in an array of identical objects, where crowding could enhance the importance of the scale at which the individual target locations are encoded. No effect of the local spatial scale of the targets was found under these conditions.     

Stress during gestation alters postpartum maternal care and the development of the offspring in a rodent model.

BACKGROUND: Epidemiological studies suggest that environmental adversity can alter parental care and thus influence child development. We addressed the question of whether stressors can directly affect parental behavior using a rodent model of stable, individual differences in maternal behavior. METHODS: Lactating rat mothers were characterized as high or low in pup-directed licking/grooming (LG) behavior, rebred, and subjected to 7 days of intermittent stress or control conditions during gestation. Female rats were mated a third time without any subsequent intervention. Maternal behavior, oxytocin receptor (OTR) binding, and offspring behavior were examined. RESULTS: Stress reduced OTR levels and pup LG of high LG mothers to levels comparable with those of low LG mothers. The adult offspring of the gestational stress/high LG mothers resembled those of low LG mothers on behavioral measures of anxiety and maternal behavior, as well as OTR levels. The results of the third mating revealed an enduring effect of gestational stress on both mother and offspring maternal LG. CONCLUSIONS: These findings suggest that stress can directly alter maternal care through the neuroendocrine systems that normally regulate this behavior. Thus, the effects of environmental adversity can be transmitted across generations through a nongenomic mechanism involving maternal care.