社会、心理因素对妊娠高血压综合征发生和发展的影响

目的：探讨社会、心理因素对妊娠高血压综合征（妊高征）（Pregnancy induced hypertrension ,PIH)发生和发展的影响。方法：对502例妊高征患者（妊高征组）和同期502例正常孕产妇（对照组）进行问卷调查和统计分析。结果：妊高征患者心理健康水平明显低于正常孕产妇，不良的社会、心理因素与妊高征发生和发展具有明显临床和统计学意义，两组比较差异显著（P＜0．05）。结论：重视不良社会、心理因素对孕产妇的影响，达到预防妊高征发生的目的。     

妊娠高血压综合征致孕产妇死亡保健因素分析

妊娠高血压综合征(以下简称妊高征)是导致孕产妇死亡的重要原因之一，为掌握孕产妇死亡原因中妊高征的比例及影响因素，探讨如何预防妊高征，降低孕产妇死亡率，我们对42例妊高征死亡孕产妇进行了分析。     

妊娠高血压综合征危险因素孕妇超重病例对照分析

妊娠高血压综合征(妊高征)是妇女妊娠时特有的并发症,是导致孕产妇和婴儿病死率升高的主要原因。有关妊高征危险因素的研究一直是学者们关注的问题。我们对1998-2000年我院住院的妊高征患者进行回顾性病例对照研究,旨在探讨孕妇超重与妊高征发病的关系。     

妊高征对孕产妇及围生儿预后影响的临床分析

目的:探讨妊高征对孕产妇及围生儿的影响及防治措施。方法:回顾分析我院2005年10月~2007年4月妊高征产妇96例,同期随机抽取无妊高征孕产妇200例作为对照组,比较两组母体并发症及围生儿情况。结果:妊高征组母体并发症、新生儿窒息、胎儿窘迫、小于胎龄儿、围生儿死亡以及病率明显高于对照组。重度妊高征高于轻度妊高征。结论:妊高征对孕产妇以及围生儿有不良影响,应重视妊高征,对其早发现、早治疗,努力改善母儿结局。     

143例妊娠高血压综合征临床分析

目的:分析不同程度妊娠高血压综合征患者的发病特点。方法:对我院3年间妊娠高血压综合征(简称妊高征)的发病情况进行分析。结果:妊高征的发病率6.49%,低于全国水平9.4%,但重度妊高征发病率25.2%,高于全国水平22.3%,流动人口妊娠高血压综合征的发病率高于常住人口。结论:消除不良因素对孕妇的影响,搞好孕产妇尤其是流动人口孕产妇管理、保健和健康教育,可望降低妊高征的发病率。     

妊娠高血压综合征的危险因素分析

妊娠高血压综合征(妊高征)是妊娠期所特有的疾病,为孕产妇和围生儿死亡的重要原因之一.其病因至今尚未阐明.为进一步探讨妊高征的危险因素,我们进行了此项调查.     

妊娠糖尿病患者血清脂肪酸结合蛋白4浓度与妊娠高血压综合征及先兆子痫的关系

目的: 探讨妊娠糖尿病患者血清脂肪酸结合蛋白4(fatty acid-binding protein 4, FABP4)浓度与妊娠高血压综合征（简称妊高征）及先兆子痫的关系。方法: 选取613例妊娠糖尿病患者作为研究对象。39例妊娠糖尿病并发妊高征及先兆子痫患者作为观察组,按1 ∶2比例选择78例孕周相近且未并发妊高征及先兆子痫的妊娠糖尿病作为对照组。采用单因素及Logistic回归分析两组临床资料,探究影响妊娠糖尿病患者并发妊高征及先兆子痫的危险因素。比较不同预测妊娠糖尿病并发妊高征及先兆子痫模型的诊断效能。结果： 613例妊娠糖尿病患者中,39例(6.36％)并发妊高征或先兆子痫,其中18例(2.94％)并发先兆子痫。观察组FABP4、中期BMI、HOMA-IR、三酰甘油及LDL水平明显高于对照组(P均<0.05),而HDL明显低于对照组(P<0.05)。FABP4>14.72 ng／mL、孕中期BMI>28.42 kg／m ²、三酰甘油>2.91 mmol／L、HDL≤1.78 mmol／L及LDL>3.08 mmol／L是妊娠糖尿病并发妊高征或先兆子痫的危险因素。妊娠糖尿病并发妊高征或先兆子痫患者血清FABP4水平与孕前BMI、孕中期BMI均呈一定的正相关;与年龄、HbAlc、HOMA-IR、总胆固醇、三酰甘油、HDL及LDL均无明显相关性。模型B预测妊娠糖尿病并发妊高征及先兆子痫的ROC曲线下面积大于模型A( Z=1.080,P=0.280)和FABP4( Z=3.801,P<0.05)。模型A预测妊娠糖尿病并发妊高征及先兆子痫的ROC曲线下面积大于FABP4(Z=2.574,P=0.010)。 结论： 检测妊娠糖尿病患者血清FABP4浓度有助于评估其并发妊高征及先兆子痫的风险。     

49例妊高征的临床观察和护理

目的：探讨通过加强妊高征的孕期保健和护理,降低其并发症和死亡率。方法：对1998年1月－2000年6月,在我院住院治疗的49例妊高征患者的临床资料及护理措施进行回顾性分析。结果：49例妊高征患者中轻度妊高征21例、中度妊高征9例、先兆子痫13例、子痫6例,伴有并发症者14例,发生率为28．6％（14／49）,围产儿死亡例,无孕产妇死亡,其中16例未接受过产前检查,占32．7％（16／49）。结论：加强孕产妇孕期保健,能早期预测、早期发现、早期治疗妊高征,加强产时及产后护理,可有效减少重度妊高征及其并发症的发生,降低母婴死亡率。     

妊高征性心脏病23例临床分析

目的：探讨妊高征心脏病的发病原因，预防措施，减少并发症，降低孕产妇和围生儿病死率。方法：回顾分析23例妊高征心脏病患者的发病原因，治疗经过及对母婴的影响，并于同期216例妊高征患者进行对比。结果：妊高征心脏病与贫血、低蛋白血症、腹水的发生率及不正确的扩容治疗有关。结论：妊高征性心脏病最根本的预防措施是早期发现并积极治疗妊高征，对妊高征心脏病的易发因素应提高警惕，心衰控制后应立即终止妊娠，以降低并发症。     

妊娠高血压综合征性心脏病临床分析

目的:探讨妊娠高血压综合征(妊高征)心脏病的发病原因,预防措施,减少并发症,降低孕产妇和围生儿病死率。方法:回顾分析21例妊高征心脏病患者的发病原因,治疗经过及对母婴的影响。结果:妊高征心脏病与贫血、低蛋白血症、腹水的发生率及不正确的扩容治疗有关。结论:妊高征性心脏病最根本的预防措施是早期发现并积极治疗妊高征,对妊高征心脏病的易发因素应提高警惕,心衰控制后应立即终止妊娠,以降低并发症。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.