妊娠期休克指数特点及与产后出血结局的相关性研究

目的:测定产妇在不同围产期的休克指数,研究围产期不同时期休克指数的特点,探讨休克指数与产后出血结果的关系。方法:选取2017年1月-2018年12月在恩平市人民医院妊娠足月待产的产妇共129例,根据患者产后是否发生产后大出血(即阴道分娩后24 h累计失血量>500 mL或剖宫产术后累计失血量>1000 mL),将产妇分为出血组(41例)和对照组(88例)。在两组产妇临产时、胎儿娩出后及产后12 h检测产妇的心率和收缩压,计算休克指数(休克指数=心率/收缩压),比较不同阶段两组产妇的休克指数,并分析不同阶段休克指数与产后出血量的相关性。结果:两组产妇在临产时和胎儿娩出后所测得的休克指数比较,差异无统计学意义(P>0.05)。但在产后12 h,出血组产妇的休克指数显著低于对照组,差异有统计学意义(P<0.05)。临产时及胎儿娩出后,产妇的休克指数与产后出血量无显著相关性(P>0.05)。但产后12 h,产妇休克指数与产后出血量呈显著负相关(R=-0.382,P=0.029)。结论:临产时和胎儿娩出后产妇的休克指数与产后出血无关,但产后12 h的休克指数与产妇产后出血有一定关系,可用于预测和发现产后出血。     

Effect of Slip Time in Forming Neo‐Esophageal Stenosis After Replacement of a Thoracic Esophagus With Nitinol Artificial Esophagus

Attempts have been made to investigate the effect of slip time of nitinol artificial esophagus for forming neo‐esophageal stenosis after replacement of a thoracic esophagus with nitinol artificial esophagus in 20 experimental pigs. The pigs whose slip time was less than 90 days postoperatively had severe dysphagia (Bown's III) immediately after they were fed, and the dysphagia aggravated gradually later on (Bown's III–IV). The pigs whose slip time was more than 90 days postoperatively had mild/moderate dysphagia (Bown's I–II) immediately after they were fed, and the dysphagia relieved gradually later on (Bown's II‐I‐0). The ratios between the diameter of neo‐esophagus in different slip time and normal esophagus were 25% (at 2 months postoperatively), 58% (at 4 months postoperatively), and 93% (at 6 months postoperatively), respectively. The relationship between nitinol artificial esophagus slip time and neo‐esophageal stenosis showed a positive correlation. After replacement of a thoracic esophagus with nitinol artificial esophagus, the artificial esophageal slip time not only affected the original diameter of the neo‐esophagus immediately, but also affected the neo‐esophageal scar stricture forming process later on. The narrowing of neo‐esophagus is caused by overgrowth of scar tissue. But there is the positive correlation between artificial esophagus slip time and neo‐esophageal stenosis, so this can be a way of overcoming neo‐esophageal stenosis by delaying slip time of artificial esophagus.     

玻璃体后脱离与高度近视眼的关系

论述了玻璃体后脱离的病因、发病机制、分类和临床特点,并揭示了玻璃体后脱离与高度近视眼的关系。     

心肌组织和血浆IGF—Ⅰ的相关性

本研究采用放射免疫分析法测定自发性高血压大鼠(SHR)和正常血压的Witar—Kyoto大鼠(WKY)血浆和心肌组织中的IGF—Ⅰ水平,以心脏混重(HW)和心脏混生/体重(HW/BW)来判定心肌肥厚。结果显示:SHR的HW较WKY有显著升高(P<0.05),HW/BW则较WKY有高度显著升高(P<0.01)。两组大鼠心肌组织中IGF—Ⅰ与血浆中的IGE—Ⅰ显示正相关(WKY:r=0.8485,P<0.05;SHR:r=0.9529,P<0.005);试验结果提示不论心脏生理和病理情况下,心脏合成和分泌的IGF—Ⅰ对循环中的IGF—Ⅰ水平均有影响,而在心肌肥厚,心肌组织中的IGF—Ⅰ病理水平增高时,影响更为明显。     

基于医生视角下网络环境对医患关系的影响研究

通过对医生群体的问卷调查,了解医生上网习惯情况、医生与患者的网络交流沟通情况、网络环境对医生实际诊疗的影响、网络环境下新闻媒体对医生的影响以及医生群体关于网络发展对医患关系影响的综合看法。指出了目前网络环境给医患关系带来的影响：互联网成为一些医生知识信息更新与积累的源地,网络成为一些医生与患者交流互动的重要平台,医生需要应对日益增多的“网络型”患者,医生对媒体负面报道的反应性出现转变。     

论提高肿瘤专业医学生医患沟通能力的重要性及其有效途径

当前我国肿瘤专业医学生存在沟通意识不强,沟通水平不足,沟通不够自信等问题。而提高医学生医患沟通能力是正确实施诊疗工作的必要前提,是减少医患纠纷的有效途径,也是适应高等医学教育发展的需求。基于此,提出提高医患沟通能力的有效途径：设立医患沟通课程及肿瘤科室实习前培训课程,建立“用心倾听＋专业疏导”模式,带教老师积极引导,学会“换位思考”,坚持“以患者为中心”的理念。     

Pain and Depression: A Neurobiological Perspective of Their Relationship

Remarkable progresses have been achieved regarding the understanding of the neurobiological bases of pain and depression. The principal role of neurotransmitters, neuromodulators, and neurohormones has been proposed in the development of pain and depression. With the progression of molecular biology, an intricate interaction among biological factors accountable to the development and management of pain and depression has been also shown in a numerous preclinical and clinical researches. This mini-review will briefly describe the current issues and future research direction for better understanding of the relationship between pain and depression.     

生殖道局部细胞免疫与黄体功能不全患者不孕的关系

目的:探讨生殖道局部细胞免疫与黄体功能不全患者不孕的关系.方法:研究纳入21例确诊为黄体功能不全(luteal phase deficiency,LPD)的患者作为研究组,同时纳入18例健康体检者最为对照组,使用放射免疫法(radiation immunity analysis,RIA)对排卵期两组血清、宫颈黏液中白细胞介素1-β(IL-1β)以及肿瘤坏死因子-α(TNF-α)的表达进行检测;使用化学发光免疫分析仪检测两组黄体期的血清孕酮水平.结果:黄体期,研究组血清孕酮水平明显高于对照组,差异有统计学意义(P＜0.05);排卵期,研究组宫颈黏液中IL-1β以及TNF-α水平与对照组比较,差异有统计学意义(P＜0.05);研究组宫颈黏液中IL-1β以及TNF-α水平与黄体中期血清孕酮水平存在负相关(r=-0.888,P＜0.05;r=-0.849,P＜0.05);宫颈黏液中IL-1β水平与TNF-α水平存在正相关(r=0.797,P＜0.05).结论:排卵期生殖道局部细胞免疫受到激活,可能是LPD患者发生不孕的主要免疫因素之一,亦能够间接的影响黄体发育从而造成LPD的发生.     

情境利害和亲疏关系对大学生良心行为的影响

目的探索在不同的情境利害关系下,亲疏关系对大学生良心行为的影响。方法使用内隐联结测验(IAT)测量100名中国大学生的良心行为。在内隐联结测验(IAT)中,通过内隐测量方法讨论情境利害关系大小和亲疏关系大小两个因素对大学生良心行为的影响效果,用利害关系不同的情境故事材料作为实验启动条件,考察在不同情境下,个体对亲疏概念与积极属性/消极属性词的联系是否存在差异;随着亲缘关系的增加,情境因素是否会影响良心行为反应产生的可能性。结果相对于非亲属概念与积极属性,亲属概念与积极属性的联系更强,即表现出了亲疏关系的良心内隐效应,而且这种效应在利害关系小的情境启动下表现更突出(t1=387.4642,t2=262.9428),两种情境下的良心内隐效应值差异极其显著(t=5.594,P0.001),且效应值不存在性别差异(t=0.141,P=0.888)和专业差异(t=1.07,P=0.287)。结论情境利害和亲疏关系对大学生良心行为有影响。