联合应用无负荷试验与脐血流测定对妊娠晚期胎儿预后的评价

目的探讨无负荷试验（NST）联合脐血流收缩期末最大的血流速度/舒张期末最大的血流速度（S/D比值）评价胎儿宫内状况及预后。方法对132例产妇进行胎心监护无负荷试验,并参照彩色超声S/D比值结果对胎儿宫内状况作出分析评价并追踪观察。结果NST混合型或无反应型者S/D比值≥3的发生率比反应型显著增高,NST混合型或无反应型且S/D比值≥3者羊水污染、新生儿Apgar评分≤7分、手术分娩的发生率明显高于反应型且S/D比值〈3者。结论NST混合型或无反应型且S/D比值≥3与胎儿不良结局关系密切,NST结果联合脐血流S/D比值可以早期发现胎儿宫内缺氧、弥补NST假阳性率过高的不足,为临床提供可靠依据。     

NST与B超胎儿生物物理评分联合监测胎儿安危

目的　探讨晚期妊娠NST与胎儿生物物理评分联合监测对胎儿预后的价值 .方法　单独应用胎儿无负荷试验 (NST)、B超胎儿生物物理评分 (BPS)及两种方法联合应用对 12 12例妊娠晚期孕妇进行观察 .结果　NST可疑型和无反应型、BPS≤ 6分中羊水污染Ⅱ、Ⅲ度、1分钟Apgar’s评分≤ 7分的发生率均明显高于BPS >6分组 (p <0 .0 0 5 ) ,NST可疑型和无反应型与BPS≤ 6分预测胎儿预后的特异性、敏感性、阳性预测值、阴性预测值分别为 75 .15 % ,86 .92 % ,4 2 .86 % ,96 .4 0 %与 98.6 4 % ,4 0 .86 % ,88.98% ,86 .11% .NST可疑型和无反应型联合BPS≤ 6分预测胎儿预后的特异性、敏感性、阳性预测值和阴性预测值分别为 98.98% ,4 6 .93% ,91.4 5 % ,88.95 % .结论　〗NST与BPS联合应用可以提高对胎儿的宫内缺氧状态的诊断 ,为临床及时纠正宫内缺氧提供了可靠的依据 .     

动脉血流超声检测胎儿宫内窘迫的临床研究

目的探讨脑、脐动脉血流监测对胎儿宫内窘迫的临床应用价值。方法对足月孕妇应用彩色多普勒检测脐动脉血流速度(S/D)值及大脑中动脉血流速度(S/D)值,并对胎儿宫内窘迫者的S/D值、新生儿脐血血气分析和新生儿Apgar评分进行比较分析。结果脐血流与大脑中动脉血流检测各项监测指标均正常者表示胎儿宫内状况与新生儿情况良好,各项监测指标均异常者提示胎儿宫内情况危急,需引起高度重视,应采取积极的措施。结论脐血流与大脑中动脉血流检测联合应用诊断胎儿宫内窘迫,预测胎儿宫内安危及新生儿预后有临床指导意义。     

NST与B超胎儿生物物理评分联合监测胎儿安危

目的探讨晚期妊娠NST与胎儿生物物理评分联合监测对胎儿预后的价值. 方法单独应用胎儿无负荷试验(NST)、B超胎儿生物物理评分(BPS)及两种方法联合应用对1212例妊娠晚期孕妇进行观察. 结果 NST可疑型和无反应型、BPS≤6分中羊水污染Ⅱ、Ⅲ度、1分钟Apgar's评分≤7分的发生率均明显高于BPS>6分组(p<0.005),NST可疑型和无反应型与BPS≤6分预测胎儿预后的特异性、敏感性、阳性预测值、阴性预测值分别为75.15%,86.92%,42.86%,96.40%与 98.64%,40.86%,88.98%,86.11%.NST可疑型和无反应型联合BPS≤6分预测胎儿预后的特异性、敏感性、阳性预测值和阴性预测值分别为98.98%,46.93%,91.45%,88.95%. 结论 ]NST与BPS联合应用可以提高对胎儿的宫内缺氧状态的诊断,为临床及时纠正宫内缺氧提供了可靠的依据.     

联合应用彩色多普勒超声及无负荷试验监测胎儿宫内缺氧

目的探讨彩色多普勒超声及无负荷试验(NST)2种方法联合应用,对产前胎儿宫内缺氧的预测价值.方法对1942例孕周为37～42w的孕妇于产前1～2w内联合应用彩色多普勒超声及NST进行检测,筛查胎儿有无宫内缺氧.结果胎儿宫内缺氧发生率为31.62%(584/1942),阳性预测值及阴性预测值分别为94.86%(554/584)及97.79%(1328/1358),准确率为96.91%(1882/1942).胎儿宫内缺氧组脐动脉血流收缩期与舒张期峰值比值(S/D)≥3发生率及剖宫产率分别为36.47%(213/584)及59.08%(345/584),无胎儿宫内缺氧组脐动脉血流收缩期与舒张期峰值比值(S/D)≥3发生率及剖宫产率分别为37.70%(512/1358),两组相比,差异极显著(χ2=75.66,P＜0.001),在胎心监护中,胎儿宫内缺氧者多以NST无反应型表现,其次为变异减速(VD)、晚期减速(LD)、早期减速(ED);无胎儿宫内缺氧者多以NST有反应型表现,其次为早期减速(ED)、NST无反应型、变异减速(VD)、晚期减速(LD).结论联合应用彩色多普勒超声及NST对孕妇进行检测,对胎儿宫内缺氧的诊断具有重要辅助价值,能显著提高诊断阳性率,为分娩方式的选择提供有价值的参考.     

脐血流S/D比值检测联合胎心监护预测胎儿宫内缺氧的价值

目的 探讨超声检测脐动脉血流速度收缩期末以及舒张期末峰值（S/D）合并胎心监护技术预测胎儿宫内缺氧的价值。方法 回顾性分析2017年2月~2019年1月我院接受产检的68例产妇的临床资料,均接受脐血流检测S/D比值合并胎心监护方式,根据参考检测数据将所有产妇分成四组:A组（反应型与S/D＜3）23例,B组（反应型与S/D≥3）17例,C组（无反应型与S/D＜3）14例,D组（无反应型与S/D≥3）14例,分析胎心监护与脐血流S/D比值检测结果,比较四组胎儿宫内缺氧及Apgar评分、羊水粪染程度。结果 四组胎儿宫内缺氧及Apgar评分比较,差异有统计学意义（P＜0.05）;D组胎儿宫内缺氧率及新生儿窒息率高于其他三组,差异有统计学意义（P＜0.05）。A组、B组、C组羊水清亮率及羊水粪染程度比较,差异无统计学意义（P＞0.05）;D组羊水清亮率低于其他三组,羊水粪染程度高于其他三组,差异有统计学意义（P＜0.05）。结论 脐血流S/D比值检测联合胎心监护方式可提高胎儿宫内缺氧判定精准性,进而改善妊娠结局。     

脐动脉血流测定与胎儿脐带绕颈

目的 :研究脐血流测定对脐带绕颈的预后评估。方法 :对 2 8例B超诊断为脐带绕颈的胎儿产前进行了脐动脉血流S/D值的测定 ,追踪观察围产儿出生时羊水性状、Apgar评分、脐带绕颈情况。 结果 :2 8例B超诊断为脐带绕颈的胎儿产时有 5例未发现脐带绕颈 ;而且S/D值 <3 .0的 2 4例 ,围产结局良好 ;S/D值 >3 .0的 4例 ,娩出时均是脐带绕颈很紧 ,其中 3例羊水粪染 ,Apgar评分均 <7分。结论 :S/D值可作为衡量脐带绕颈对胎儿危害程度的一种方法 ,结合B超为临床决定分娩方式提供依据     

妊娠晚期脐血流异常的围产儿预后分析

目的探讨妊娠晚期胎儿脐血流S／D值异常者的围产儿预后。方法分析2005年1月-2006年12月在我院分娩，S／D值异常产妇207例，按S／D异常值进行分组，并与S／D值正常组比较。结果S／D值异常组不良围产儿结局发生率明显增高。与S／D值正常组相比较，差异有显著性（P〈0．01）；S／D值≥4与3≤S／D〈4相比较，差异有显著性（P〈0．05）。S／D值越高，围产儿预后越差。结论妊娠晚期脐血流S／D值可作为判断胎儿宫内缺氧的指标，对围产儿结局有很好的监测作用。     

子痫前期患者胎盘血流异常的高危因素及围产儿预后

目的 探求子痫前期患者胎盘血流异常的高危因素及其对围产儿预后的影响.方法 回顾性分析255例子痫前期患者的临床资料,其中脐血流S/D比值≥3.0者82例,脐血流S/D比值<3.0者173例.B超检测脐动脉S/D比值,联合患者血压、血液流变学指标及围产儿预后进行相关性分析.结果 子痫前期患者脐血流异常组母体血压及血液流变学指标较脐血流正常者有显著升高,母体血压、血液红细胞压积及D二聚体与脐血流S/D比值具有显著正相关性.子痫前期组胎儿宫内生长受限发生率及新生儿窒息率较正常对照组均有显著升高,子痫前期脐血流异常组较脐血流正常组胎儿宫内生长受限发生率及新生儿窒息率亦有显著升高.结论 子痫前期患者血压增高及血液高凝是胎儿脐血流异常的高危因素,胎儿脐血流异常者易出现围产儿预后不良,对于多种高危因素并存时应积极治疗必要时终止妊娠.     

不同胎儿监护技术对胎儿宫内监护的临床意义

目的探讨不同胎儿监护技术对胎儿宫内监护的临床意义.方法以胎儿电子监护仪、胎儿心电图机、多普勒超声脐血流分析仪3种不同原理的胎儿监护仪器,对200例足月妊娠妇女进行产前监护,并就监护结果、围产结局进行分析比较.结果ECG正常190例,检出异常10例,阳性率5%.NST无反应型6例,阳性率3%.S/D值≥3为11例,阳性率5.55%.200例中出现各种不良围产结局有128例次.不良围产结局中产前监护阳性的NST5例,FEOG 5例,S/D10例.(P>0.05).不同监护技术阳性结果的围产结局比较NST阳性的有50%出现异常围产结局,FEOG与S/D则分别为50%和81.9%(P>0.05).单项监护阳性的异常围产结局率36.36%,监护两项以上阳性则异常围产结局率80%(P<0.05).结论3项监护技术的联合应用,可提高胎儿宫内监护的安全性和准确性.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.