耻骨联合长度及骨盆出口前后径与头位难产的关系

目的：观察耻骨联合长度及骨盆出口前后径与头位难产的关系。方法：将患者分为头位难产组116例和自然分娩组116例，分别测量身高、体重、腹壁厚度、耻骨联合长度、出口前后径等骨盆径线，详细记录产程并绘制产程图，记录分娩方式、新生儿体重、B超判断胎方位并测量胎儿双顶径。结果：2组胎头衔接情况相似，头位难产组耻骨联合长度明显较自然分娩组长，相反，出口前后径则较小，其他各项比较无明显差异。结论：耻骨联合过长及出口前后径较小与头位难产有关，也应考虑作为骨盆测量常规项目。     

耻骨联合与头位难产614例分析

头位难产占难产总数的80％左右,近十年来引起产科工作者高度重视,正确处理头位难产,对降低围产儿死亡率及提高人口素质有其重大意义。骨盆与头位难产有直接关系。耻骨联合与头位难产关系更为密切,通过614例随机抽样足月初产妇观测,报告如下。1资料及方法1.1资料来源:研究对象系1988年在我院分娩的614例足月、单胎、头位,骨盆外测量正常的初产妇,无明显妊娠合并症及并发症。1.2观测项目:测量产妇的身高、体重、腹厚、耻骨联合长度、出口前后径、第一产程、第二产程、分娩方式、胎方位、婴儿体重及头围。     

骨盆倾斜度的改变与难产的关系

妇女在不穿鞋直立时骨盆入口平面与地平面的角度称为骨盆倾斜度。在非孕期为50°～55°之间，不超过60°，随着妊娠月份的增加倾斜度可以增加3°～7°：当站立时骶骨胛与耻骨联合上缘的同一水平高度之差10cm。正常情况下妊娠骨盆倾斜度增加在60°～70°时范围内活动，但是不影响自然分娩，当骨盆倾斜度70°时，也就是骶骨胛向前移动，耻骨弓向后移动，临床上表现为耻骨联合稍低下，骨盆的前后径稍缩短，这时的产轴方向与原先正常的产轴方向形成小的夹角，影响胎头下降，内旋转、衔接等分娩机转，所以倾斜度大于70°时称倾斜度过大，阻碍胎头入盆，由于产力方向后移，     

胎膜早破与头位难产关系的探讨

胎膜早破与头位难产关系的探讨任太芳，毛卫勤，吴秀兰我院１９８７年６月至１９９２年６月住院待产的头先露产妇共２５４２例，发生头位难产６０例，其中胎膜早破合并头位难产３４例。本文就胎膜早破与头位难产的关系加以探讨。回临床资料１．ｌ一般资料６０例头位难产产...     

头位难产与剖宫产

头位难产与剖宫产卢彩虹李枫安阳市第二人民医院（４５５０００发生于头先露的难产称为头位难产，是由凌萝达教授１９７８年提出的。因头位难产而剖宫产的比例有日益增加的趋势，基层的产科工作者对难产中的臀位、横位概念明确，但对头位难产则认识极差。现就我院近两年来...     

胎膜早破与头位难产关系的探讨

目的：探讨胎膜早破与头位难产的关系。方法：对379例足月头先露产妇胎膜早破病例进行回顾性分析。结果：胎膜早破合并头位难产的发生率明显高于非胎膜早破者,本文中46.1%的胎膜早破发生头位难产。胎膜早破往往是头位难产的先兆。结论：在胎膜早破时更应警惕头位难产的发生,以便尽早做出诊断与处理,确保母子安全。     

胎膜早破与头位难产关系探讨

胎膜早破（PROM）是产科临床常见的产前并发症，在头位分娩中，往往是难产的早期信号。现着重探讨胎膜早破与头位难产两者的关系，以引起产科工作者的重视。     

头位难产的识别与处理

<正> 随着围产医学的不断发展与普及,横位、臀位等异常胎位的发生率已明显下降,97％的胎方位是头先露。如何从97％的头先露中将难产识别出来,是产科医生、助产士每天工作中都要面对的问题。在头位分娩中,顺产和难产没有明显的界限,除有明显的骨狭窄者外,绝大多数的难产都需要经历一段产程后,才逐渐表现出来。产程开始后,头先露的胎头多数取枕横位或枕斜位入盆,产时绝大多数胎头在有效产为作用下,在骨盆腔内采取一系列适应性的动作而转成枕前位,最终以枕前位的分娩方式进行分娩。当胎头不能以枕前位     

头位难产与胎方位的关系

发生于头先露的难产为头位难产,其发生率高,对母婴危害均大。本文就我院4年来对胎头方位异常与头位难产的关系进行回顾性分析,旨在加深对头位难产的认识,探讨诊断处理方法,以改善母儿预后。1　临床资料1.1　一般资料　我院自1993年12月至1997年12月分娩3065例,其中头位分娩2969例,占分娩总数的96.86%;臀位94例,占3.06%;横位2例,占0.06%。发生头位难产465例,为头位分娩总数的15.66%,占难产总数的82.88%。其中因胎头位置异常发生难产356例,占头位难产的76.56%(356/465)。1.2　头位难产的原因　发生头位难产的原因从产力、产道和胎儿三大因素进…     

胎膜早破与头位难产关系临床分析

目的探讨胎膜早破与头位难产的关系.方法回顾性分析2002年1月～2003年12月住院分娩的胎膜早破孕妇180例,对其中的足月、初产、头位分娩156例和随机抽样、条件相同、无胎膜早破者160例进行对比分析比较.结果胎膜早破组临产后的胎头未衔接率、骨盆狭窄率、头盆不称率、胎位异常率、难产率及产褥感染率高于对照组,有明显差异.结论胎膜早破是头位难产的早期信号,要重视胎膜早破对孕产妇及新生儿的危害,及时处理,降低母婴并发症.     

栓线长度,直径及大鼠体重及栓线法大鼠局灶性脑缺血模？…

目的：为提高栓线法大鼠局灶性脑缺血（ＭＣＡＯ）模型的成功率和稳定性,探讨大鼠体重,栓线插入长度和直径与ＭＣＡＯ模型成功的关系。     

栓线长度、直径及大鼠体重与栓线法大鼠局灶性脑缺血模型关系的研究

目的:为提高栓线法大鼠局灶性脑缺血(NCAO)模型的成功率和稳定性,探讨大鼠体重、栓线插入长度和直径与MCAO模型成功的关系.方法:利用2×2×2析因设计,通过检测神经功能缺陷评分和脑梗塞体积,分析大鼠体重、栓线插入长度和直径与UCAO模型成功的关系.结果:大鼠体重、栓线直径两水平之间有差异(P＜0.05),栓线插入长度两水平之间无差异(P＜0.05);大鼠体重、栓线直径之间有正交互作用(P＜0.05),其余两两之间以及三者之间无交互作用(P＞0.05).结论:最佳造模方案是大鼠体重250～300g、线长17mm或18mm、线直径0.28mm,该方案制作的MCAO模型成功率高,重复性好.     

经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的效果研究

目的比较不稳定性骨盆骨折患者分别采用经皮骶髂螺钉内固定及骶髂关节前方钢板固定治疗后的临床效果。方法本次研究中的110例不稳定性骨盆骨折患者均为2010年9月~2013年6月来我院就诊的病例,将其按照不同的治疗方式分为观察组及对照组各55例,观察组采用经皮骶髂螺钉内固定治疗,对照组采用骶髂关节前方钢板固定治疗,比较两组围术期各项观察指标、术后并发症发生情况、患者的复位效果(术后Matta评分优良率)、患者的疼痛、骨折愈合时间及功能性恢复状况(术后Majeed功能评分总优良率)。结果观察组的术中出血量与对照组比较明显较少,伤口总长度较小,手术时间、术后发热时间及住院时间均明显较短,并发症发生率明显较低,术后Matta评分及Majeed功能评分总优良率均明显较高,以上各项指标在两组间均具有显著性差异(P<0.05)。结论不稳定性骨盆骨折患者采用经皮骶髂螺钉内固定治疗安全有效,可以作为一种有效的微创手术方法在临床推广应用。     

贵州地区汉族特定人群男性手长、足长与身高的关系

目的 研究贵州地区汉族特定人群男性手长、足长及身高的关系。方法 测定1003名汉族特定人群男性的手长、足长及身高，并对数据进行统计学处理。结果 建立了贵州地区汉族特定人群男性手长、足长、手长和足长推测身高的回归方程。结论 以左手为变量推测身高之方程较为接近实际。     

中国汉族人群中20p12染色体上三个单核苷酸多态性与后纵韧带骨化发生及其严重程度的关系研究

Background Ossification of the posterior longitudinal ligament （OPLL） is characterized by the replacement of ligamentous tissue with new ectopic bone formation, and has a strong genetic background. Because of the abnormal bone metabolic features and the strong genetic component, osteoporosis is a related disorder with OPLL. Three polymorphisms on chromosome 20p12 were identified associated with the risk of osteoporosis and osteoporotic fracture.The rs996544 （C/T） ＂TT＂ and rs965291 （G/A） ＂AA＂ genotypes conferred higher risks for vertebral and hip fractures. The osteoporosis haplotype is defined by two polymorphisms, rs1116867 （A） and D35548 （T）. However, it remains unknown whether these three polymorphisms predispose to an increased frequency and severity of OPLL in Han Chinese patients.Methods A total of 420 OPLL patients and 506 age- and sex-matched controls were studied. Three single nucleotide polymorphisms （SNPs）, rs996544 （C/T）, rs965291 （G/A） and rs1116867 （A/G）, were analyzed by direct sequencing.Associations between these SNPs with the occurrence and extent of OPLL were statistically evaluated.Results There was no significant association between the rs996544 （C/T） polymorphism and the prevalence of OPLL.The rs1116867 （A/G） polymorphism ＂AG＂ genotype was associated with the occurrence of OPLL. The rs1116867 （A/G） polymorphism ＂G＂ allele was associated with the occurrence of OPLL, but not with the extent of OPLL. The rs965291 （G/A） polymorphism in female patients was statistically different between cases and controls （P 〈0.05）. The rs965291 （G/A） polymorphism ＂A＂ allele was associated with the occurrence of OPLL in female patients. For the rs965291 （G/A）polymorphism, patients with the ＂A＂ allele （genotype, ＂AG＂ or ＂AA＂） showed a significantly greater number of ossified cervical vertebrae than those without the ＂A＂ allele （genotype, ＂GG＂, P 〈0.05）, particularly in female patients.Conclusions The rs1116867 （A/G） and rs965291 （G/A） polymorphisms on chromosome 20p12 are associated with the occurrence and the extent of OPLL, at least in Han Chinese subjects. Our data should advance our understanding of the molecular etiology of OPLL and may guide approaches to prevent the onset of OPLL.     

气道壁厚度与外径之比和气道壁厚度占气道总横截面积的百分比在哮喘患者病情评估中的应用价值

目的探讨气道壁厚度与外径之比和气道壁厚度占气道总横截面积的百分比在哮喘患者病情评估中的应用价值。方法选择60例哮喘患者(观察组)和正常健康人60人作为对照组,所有入选者经治疗1周后与对照组同样行胸部高分辨CT扫描。结果经过测量,观察组的左尖与右尖的T/D值明显大于正常对照组(P<0.05),气管壁厚度增厚明显。同时与对照组相比,观察组的左尖与右尖的WA%明显增大(P<0.05)。结论高分辨CT显示哮喘患者气道壁显著增厚,可用于测定气道壁厚度,评估哮喘患者气道重构,可为临床提供良好的无创性的、直观的诊断鉴别诊断工具。     

确定多术式单病种临床路径实施范围和住院时间方法的研究

目的：探讨多种手术方式的单个病种在实施临床路径（Clinical pathway，CP）时确定其实施范围和住院时间的途径。方法：查阅一定时期内腰椎间盘突出手术患者的住院信息，按不同术式对其分组后进行组间的差异性分析，对可以纳入同一CP流程的组将其诊疗过程进行作业流程重组。结果：把差异不显著的术式纳入同一CP流程并确定了其CP住院时间。结论：在CP的设计阶段，对不同术式进行组间差异性分析并运用科学的方法确定CP住院时间，为CP的实施奠定好的基础。     

A single nucleotide polymorphism in the human BMP-2 gene (109T>G) affects Smad signaling pathway and the predisposition to ossification of posterior longitudinal ligament of spine

Background Although various systemic and local factors such as abnormal carbohydrate or calcium metabolism, aging and hormonal disturbances have been suggested as causes of Ossification of the posterior longitudinal ligament (OPLL), the etiology of OPLL is not fully understood. The purpose of this study was to investigate whether BMP-2 is a candidate gene to modify the susceptibility of OPLL and the mechanism of ossification in signal transduction. Methods A total of 420 OPLL patients and 506 age- and sex-matched controls were studied. The complete coding sequence of the human BMP-2 gene were analysed through PCR and direct sequencing, all the SNPs were detected and genotype. The BMP-2 expression vectors containing positive polymorphism were constructed and transfected to the C3H10T1/2 cell. The expression of BMP-2 and Smad signal pathway in positive cell clones were detected by western blotting. The ALP activity was detected by quantitative detection kits. Results The frequencies for the 109T>G and 570A>T polymorphisms were difference between the case and control group. The “TG’ genotype in 109T>G polymorphism is associated with the occurrence of OPLL, the frequency of the “G” allele is significantly higher in patients with OPLL than in control subjects (P<0.001). The “AT’ genotype in 570A>T polymorphism is associated with the occurrence of OPLL, the frequency of the “T” allele is significantly higher in patients with OPLL than in control subjects (P=0.005). Western blot analysis showed that the expression of P-Smad1/5/8 protein transfected by wild-type or mutant expression vectors were significantly higher than control groups (P<0.05), but there was no statistical difference in each experimental group (P>0.05). The expression of Smad4 protein transfected by wild-type or mutant expression vectors were significantly higher than control groups (P<0.05), the expression of Smad4 protein transfected by pcDNA3.1-BMP2 (109G) and pcDNA3.1-BMP2 (109G, 570T) were significantly higher than the other experimental groups(P<0.05). The ALP activity increase has been detected in pcDNA3.1-BMP2 (109G) and pcDNA3.1-BMP2 (109G, 570T) transfected cells to 4 weeks after stably transfection. The activity ALP results were (30.56±0.46) nmol/minute/mg protein and (29.62±0.68) nmol/minute/mg protein, respectively. There was a statistical difference compared with the other experimental groups (P<0.05). Conclusions The BMP-2 is the predisposing gene of OPLL. The “TG’ genotype in the 109T>G and the “AT’ genotype in the 570A>T polymorphisms are associated with the occurrence of OPLL. In the intracellular signalling transduction, the 109T>G polymorphism in exon-2 of BMP-2 gene is positively associated with the level of Smad4 protein expression and the activity of ALP. Smad mediated signalling pathway plays an important role during the pathological process of OPLL induced by SNPs of BMP-2 gene.     

A single nucleotide polymorphism in the human bone morphogenetic protein-2 gene (109T>G) affects the Smad signaling pathway and the predisposition to ossification of the posterior longitudinal ligament of the spine

Background Although various systemic and local factors such as abnormal carbohydrate or calcium metabolism,aging,and hormonal disturbances have been suggested as causes of ossification of the posterior...     

Association between two polymorphisms of the bone morpho- genetic protein-2 gene with genetic susceptibility to ossification of the posterior longitudinal ligament of the cervical spine and its severity

Background Ossification of the posterior longitudinal ligament （OPLL） has a strong genetic background. Previous studies have shown that bone morphogenetic protein-2 （BMP2） and BMP2 mRNA are expressed in ossifying matrix and chondrocytes adjacent to cartilaginous areas of OPLL tissues and mesenchymal cells with fibroblastic features in the immediate vicinity of the cartilaginous areas. It is suggested that BMP2 plays different roles in the different stages of development of OPLL. However, it remains unknown which factors induce ligament cells to produce BMP2. Methods OPLL patients （n=-192） and non-OPLL controls （n=304） were studied. Radiographs of the cervical spine were analyzed for extent of OPLL. We investigated whether single nucleotide polymorphisms of exons 3（-726） T/C and 3（-583） NG in the BMP2 gene are statistically associated with genetic susceptibility to OPLL in Chinese Han subjects. Results There was no statistical difference between the occurrence of exons 3（-726） T/C and 3（-583） NG and the occurrence of OPLL in the cervical spine. However, there was a significant association between occurrence of exon 3（-726） T/C polymorphism and occurrence of OPLL in males of cases and controls in the cervical spine. In addition, no significant association was found between the exons 3（-726） T/C and 3（-583） A/G with number of ossified cervical vertebrae in OPLL patients. Conclusions Exon 3（-583） A/G polymorphism in BMP2 gene is not associated with the occurrence and the extent of OPLL in the cervical spine. Chinese Han male patients with TC and CC genotypes in exon 3（-726） T/C have genetic susceptibility to OPLL but not to more extensive OPLL in the cervical spine.