妊娠期糖尿病对妊娠结局的影响分析

妊娠期糖尿病(GDM)是指孕妇在妊娠期出现或发现的糖尿病,妊娠期糖尿病对母儿均有较大危害,如不能得到及时控制,将导致母儿的患病率和死亡率明显升高。本文对137例妊娠期糖尿病产妇与137例非糖尿病产妇的临床资料进行回顾性分析,探讨妊娠期糖尿病对产妇妊娠期并发症、分娩方式及新生儿的影响。1临床资料选取2007—2013年分娩的妊娠期糖尿病产妇137例为观     

妊娠期糖尿病与妊娠期高血压疾病的关系

目的:探讨妊娠期糖尿病与妊娠期高血压疾病的关系.方法:对2009年3月～2011年3月分娩的妊娠期糖尿病孕妇和发生妊娠期高血压疾病孕妇的临床资料进行回顾性分析.并将其分为单纯妊娠期糖尿病组227例(A组)和妊娠期糖尿病并发高血压疾病组35例(B组),再随机选同期正常妊娠200例(C组)为对照组;比较3组孕妇空腹血糖及血脂水平.结果:孕妇妊娠期糖尿病发生率2.48%,妊娠期高血压疾病发生率3.93%,妊娠期糖尿病并发妊娠期高血压疾病发生率13.36%.3组TC、LDL-C、TG、FBG差异有显著性 (P＜0.05),而3组HDL-C差异无显著性.结论:妊娠期糖尿病孕妇易发生妊娠期高血压疾病,故应对妊娠期血糖异常者进行血糖及血脂监测,使血糖维持在正常范围,减少PHD的发生.     

妊娠期糖尿病与妊娠并发症的相关性

目的研究妊娠期糖尿病与妊娠并发症的相关性。方法对住院分娩的124例妊娠期糖尿病产妇进行总结,并与同期非妊娠期糖尿病产妇210例作对照。所有的病例常规行胎盘病理等检查。结果胎盘病理提示32例(25.81%)有急慢性胎膜、胎盘炎,24例(19.35%)曾因先兆流产或先兆早产保胎治疗,13例(10.48%)有自然流产或死胎病史,与非妊娠期糖尿病产妇比较差异均有统计学意义(P<0.05)。结论妊娠期糖尿病影响母婴健康,增加妊娠并发症,需加强妊娠期糖尿病孕妇的管理,早期诊治,改善妊娠结局。     

妊娠期糖尿病60例临床分析

目的:探讨妊娠期糖尿病对孕产妇及围生儿的影响.方法:选择60例妊娠期糖尿病孕产妇(观察组)与60例同期非妊娠期糖尿病孕产妇(对照组),对两组的孕产期并发症、围生儿预后进行对比分析.结果:妊娠期糖尿病组妊娠期高血压综合征(18.3%)及巨大儿(16.7%)发病率均高于对照组(分别为3.3%),两组比较差异显著(P<0.05).结论:妊娠期糖尿病孕产期并发症明显增高,及时发现、及时处理可以改善孕产妇及围生儿预后.     

妊娠期糖尿病63例临床分析

目的探讨妊娠期糖尿病对母婴预后的影响。方法对收治的妊娠期糖尿病孕妇63例(研究组),同期随机抽取非妊娠期糖尿病孕妇60例(对照组)进行分析。结果研究组的剖宫产、妊娠高血压疾病、羊水过多、胎儿宫内发育迟缓、新生儿窒息、新生儿低血糖发生率均高于对照组(P均<0.05)。结论妊娠期糖尿病是危害孕妇及围产儿的疾病,应及时诊断和治疗,减少妊娠期糖尿病的母婴并发症。     

妊娠期糖尿病25例临床分析

目的:探讨妊娠期患者预防糖尿病的措施。方法:以25例妊娠期糖尿病患者作为研究组,非妊娠期糖尿病患者30例作为对照组。用2χ检验。结果:对孕妇影响及新生儿影响方面,研究组与对照组比较,有高度显著性差异(P<0.01)。结论:提示妊娠期糖尿病的母婴并发症明显增加。进行糖尿病筛查,及时发现妊娠期糖尿病,较好控制血糖,加强围生期妊娠期糖尿病孕妇的管理,可降低妊娠期糖尿病母婴的并发症和降低剖宫产率。     

孕妇膳食行为在孕前体质量指数与妊娠期糖尿病发生之间的中介效应分析

目的 探讨孕妇膳食行为在孕前体质量指数与妊娠期糖尿病发生之间的中介效应,为临床妊娠期糖尿病预防提供参考。方法 选择2021年1月1日至2022年12月31日某院接诊的297例孕妇,采用孕妇饮食行为量表评估孕妇膳食行为,收集孕前体质量指数,孕24至28周都接受妊娠期糖尿病筛查。分析孕妇膳食行为在孕前体质量指数与妊娠期糖尿病之间的中介效应。结果 本组共确诊72例妊娠期糖尿病,妊娠期糖尿病组年龄大于非妊娠期糖尿病组(P<0.05),糖尿病家族史比例高于非妊娠期糖尿病组(P<0.05),孕前体质量指数、孕期体重增加多于非妊娠期糖尿病组(P<0.05),孕妇膳食行为评分低于非妊娠期糖尿病组(P<0.05)。孕前体质量指数对妊娠期糖尿病具有正向预测作用(β=1.512),对孕妇膳食行为评分具有负向预测作用(β=-1.302,),增加中介变量孕妇膳食行为,孕前BMI对妊娠期糖尿病的效应减弱(β由1.512变为1.032),提示孕妇膳食行为评分在孕前体质量指数对妊娠期糖尿病之间起部分中介效应。结论 孕妇膳食行为部分中介孕前体质量指数对妊娠期糖尿病的影响,合理膳食有助于维持正常的...     

妊娠期糖尿病的复发率、复发的危险因素及复发性妊娠期糖尿病母婴预后的分析

目的:调查了解妊娠期糖尿病的复发率,分析妊娠糖尿病复发的危险因素,并探讨复发性妊娠期糖尿病的母婴预后情况。方法:选择本院产科就诊且既往有妊娠期糖尿病的500例孕妇(2015年1月-2018年3月)进行研究,根据孕妇本次妊娠是否复发妊娠期糖尿病分为观察组、阴性对照组,比较其临床资料,对妊娠期糖尿病复发危险因素进行分析。另选取100例初发妊娠期糖尿病孕妇作为阳性对照组,比较三组孕妇的母婴预后情况。结果:(1)500例既往妊娠期糖尿病孕妇本次妊娠复发糖尿病127例,妊娠期糖尿病的复发率为25.40%。(2)经单因素分析、多因素Logistics线性回归分析后发现,前次空腹血糖、前次餐后2 h血糖、本次孕前BMI指数是导致妊娠期糖尿病复发的危险因素。(3)观察组、阳性对照组的阴道自然分娩率、新生儿Apgar评分均较阴性对照组更低,其剖宫产率、妊娠不良结局发生率均较阴性对照组更高(P0.05);观察组与阳性对照组的分娩方式、妊娠不良结局发生率比较差异均无统计学意义(P0.05),但观察组产后6个月的遗留糖耐量异常率较阳性对照组更高(P0.05)。结论:既往妊娠期糖尿病孕妇复发风险较高,其复发危险因素主要为前次血糖高、本次孕前BMI指数高,而复发性妊娠期糖尿病易出现妊娠不良结局,孕妇产后发生糖尿病的风险高于初发妊娠期糖尿病孕妇。     

母血、脐血性激素结合球蛋白水平与妊娠期糖尿病

目的探讨妊娠期糖尿病(GDM)孕母、正常孕母,母血、脐血性激素结合球蛋白水平.方法采用ELISA 法测定51例36～41周妊娠期糖尿病孕母,正常孕母母血、脐血性激素结合球蛋白水平,将其分为病例组(妊娠期糖尿病)25例及对照组(正常组)26例.结果病例组胎儿母血、脐血存在低性激素结合球蛋白水平,与胎儿性别无关.结论妊娠期糖尿病孕母胎儿存在低性激素结合球蛋白水平,妊娠期糖尿病孕母所孕育的胎儿体内可能存在胰岛素抵抗.     

妊娠期糖尿病新标准的临床应用体会

目的探讨妊娠期糖尿病(GDM)新标准的应用对围生期母儿结局的影响。方法通过对2011年采用妇产科学妊娠期糖尿病诊断标准(旧标准)的4 257例孕妇及对2012年采用国际糖尿病与妊娠研究组IADPSG标准(新标准)的4 792例孕妇进行回顾性研究,分析两组妊娠期糖尿病的检出率及母儿并发症的发病率。结果新标准的妊娠期糖尿病的检出率明显高于旧标准,但母儿并发症的发病率显著低于旧标准。结论应用妊娠期糖尿病新标准,能及早发现妊娠期糖尿病患者,分层管理,控制血糖,有利于改善母儿预后。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.