早期先兆流产产妇的妊娠结局相关因素的Logistic回归分析

目的探讨早期先兆流产的妊娠结局并分析其相关因素。方法回顾性分析我院收治的180例早期先兆流产妇女的妊娠结局,分别采用单因素分析和多因素回归分析分析引发不良妊娠结局的因素。结果单因素分析结果显示:不良妊娠结局组的高龄妊娠、污染接触职业、低收入、阴道大量出血、宫内大血肿比例明显高于良好妊娠结局组(P<0.01)。Logistic回归分析结果显示:阴道大量出血、宫内大血肿进入回归方程是导致不良妊娠结局的独立危险因素。结论阴道大量出血、宫内大血肿是早期先兆流产不良妊娠结局的独立危险因素,临床中应予以足够重视。     

影响早期先兆流产结局的相关因素分析

目的：探讨影响早期先兆流产的相关因素。方法对120例早期先兆流产孕妇的年龄、职业、收入、阴道出血量、宫内血肿、孕产次等因素进行统计分析，并与妊娠结局情况进行相关分析。结果本组120例早期先兆流产孕妇不良结局的发生率为25.83%，高龄孕妇、从事化学剂毒物事业、收入底下、阴道大量出血及宫内大血肿患者的不良妊娠结局发生率明显高于良好妊娠结局（P＜0.05）。结论孕妇年龄、职业、收入、阴道出血量及宫内是否有大血肿等因素与早期先兆流产的妊娠结局相关，临床可根据患者个体情况给予相应的干预措施，以减少不良妊娠结局的发生率。     

对69例先兆流产产妇妊娠结局及相关影响因素的分析

目的：分析先兆流产产妇的妊娠结局及影响其妊娠结局的相关因素。方法：对2009年01月至2012年12月我院收治69例先兆流产产妇的临床资料进行分析和跟踪调查,分析其妊娠结局及影响其妊娠结局的相关因素。结果：这69例先兆流产产妇中,有30例产妇出现不良妊娠结局（占43.48%）,影响其妊娠结局的相关因素包括在孕早期发生阴道流血、发生产前阴道大出血、患有子宫疾病、有家族流产史、高龄妊娠等。结论：为了维护胎儿的健康,降低流产率,妊娠期女性应积极防治妇科疾病,保持健康的身心状态及生活环境,纠正不健康的生活习惯,并应在发生先兆流产时采取积极有效的干预措施。     

先兆流产不良妊娠结局危险因素分析及干预对策

目的：探讨早期先兆流产患者妊娠不良结局的相关危险因素,总结临床护理干预对策.方法：对2012年3月～2013年4月间在我院门诊就诊及住院安胎治疗的230例早期先兆流产病例进行调查,对预设危险因素与不良妊娠结局发生率的相关性进行研究,测量数据行二分类多因素Logistic回归分析.结果：阴道大量出血、多次流产史、既往宫腔操作次数、心理应激及职业（从事有毒化学物质接触职业）因素与先兆流产不良妊娠结局的发生率存在显著相关性（P＜0.05）.结论：根据危险因素和回归预测结果制定合理的临床干预对策以促进孕期保健,对改善妊娠结局有积极意义.     

妊娠早期先兆流产高龄孕妇保胎治疗后妊娠失败的影响因素

目的：分析妊娠早期先兆流产高龄孕妇保胎治疗后妊娠失败的影响因素。方法：选取2021年1月至2023年1月该院收治的230例妊娠早期先兆流产高龄孕妇进行横断面研究,均进行保胎治疗,并判定妊娠结局,根据妊娠结局将其分为继续妊娠组和妊娠失败组。采用Logistic回归分析妊娠早期先兆流产高龄孕妇保胎治疗后妊娠失败的影响因素。结果：230例妊娠早期先兆流产高龄孕妇保胎治疗后妊娠失败45例,发生率为19.57%(45/230);两组年龄、孕周、孕次、孕前体质量指数、人工流产史、早产史、孕期吸烟史、孕期饮酒史、合并阴道炎比较,差异均无统计学意义（P>0.05）;妊娠失败组黄体功能不全、有自然流产史、有宫内大血肿、β-人绒毛膜促性腺激素（β-hCG）<9000 mU/mL占比均高于继续妊娠组,差异有统计学意义（P<0.05）。Logistic回归分析结果显示,黄体功能不全、有自然流产史、有宫内大血肿、β-hCG<9000 mU/mL均为妊娠早期先兆流产高龄孕妇保胎治疗后妊娠失败的危险因素（OR>1,P<0.05）。结论：黄体功能不全、有自然流产史、有宫内大血肿、β...     

血清孕酮对鉴别宫内早早孕、难免流产、先兆流产及异位妊娠的价值

目的 探讨宫内早早孕、难免流产、先兆流产及异位妊娠鉴别中血清孕酮检测的价值。方法 对2009年6月～2011年5月在我院妇科就诊的180例孕妇依据随访和妊娠结果进行分组对比分析。结果 血清孕酮检测结果显示血清孕酮值宫内早孕组〉先兆流产组〉难免流产组〉异位妊娠组,组间比较差异具有显著性（P〈0．05）。结论 血清孕酮检测可为宫内早早孕、难免流产、先兆流产及异位妊娠的早期鉴别确诊提供参考。     

孕早期血清β-HCG、E2、P联合测定及E2／P比值的临床意义

目的探讨血清人绒毛膜促性腺激素（β-HCG）、雌二醇（E2）、孕酮（P）及雌二醇／孕酮（E2／P）在早期鉴别异位妊娠、先兆流产和难免流产中的价值。方法对105例疑诊为异常妊娠患者作血清E2、P及β-HCG测定,根据妊娠结局分异位妊娠组（D组）、先兆流产组（B组）、难免流产组（C组）,65例正常宫内妊娠组,为对照组（A组）。结果D组P值明显低于宫内妊娠组（A、B及C组）（P〈0．01）;异常妊娠（B、C及D组）E2均低于A组（P〈0．01）。48h血清β-HCG动态测定,异常妊娠各组较A组上升斜率减低,倍增时间延长（P〈0．01）。D组E2／P比A组高,B组及C组E2／P比A组低（P〈0．05）。先兆流产组、难免流产组β-HCG、E2明显低于对照组（P〈0．01）,E2／P比值低于对照组（P〈0．05）。结论血清β—HCG、E2、P联合测定并结合E2／P比值来鉴别孕早期异常妊娠有一定的诊断价值。     

不良妊娠结局的环境危险因素影响强度及交互作用研究

目的探讨引起不良妊娠结局的主要环境危险因素,分析这些危险因素之间的影响强度及交互作用.方法 采用回顾性调查法,将确诊为不良妊娠结局的120份病例和同期妊娠正常的80份病例进行对照.结果 孕妇既往不良妊娠史即流产史对不良妊娠结局的影响强度最大(OR=28.65),并且随着流产次数的增加其危险性增加;吸烟及饮酒是导致不良妊娠结局的重要因素,包括配偶吸烟(OR=6.24)、孕前被动吸烟(OR=5.15)、孕期被动吸烟(OR=2.81)、配偶饮酒(OR=3.07);夫妻双方不良环境接触史及孕期患病也会影响妊娠结局(OR值分别为3.23、3.22、1.83).结论 避免多次流产,戒除吸烟、饮酒等不良嗜好,减少与宠物、农药、甲醛及电磁辐射等的接触,孕期增强身体免疫力,对降低不良妊娠结局有重要作用.     

剖宫产术后瘢痕妊娠发生的危险因素分析?

目的：探讨剖宫产术后发生瘢痕妊娠的危险因素。方法采用病例对照研究方法,以48例剖宫产术后瘢痕妊娠(CSP)患者为观察组,随机抽取50例同期有剖宫产史但再次妊娠位置正常患者为对照组。收集临床资料,通过单因素分析和 Lo-gistic 回归分析,确定剖宫产术后瘢痕妊娠的独立危险因素。结果单因素分析显示两组的学历、终止宫内妊娠以外的盆腹腔手术史、流产次数、末次剖宫/流产时间、早孕期阴道流血差异均有统计学意义(P <0.05)。多因素分析发现末次剖宫/流产时间(OR=0.983,95%CI ：0.970~0.997)、早孕期阴道流血(OR =35.937,95%CI ：15.264~84.611)为 CSP 发病的独立危险因素。结论对有剖宫产病史的停经患者,首次就诊时应追问人流史及早孕期是否有阴道流血,结合 B 超等进行早期诊断,从而早期治疗以改善患者预后。     

体外受精-胚胎移植后妊娠早期阴道流血对妊娠结局的影响

目的 探讨体外受精-胚胎移植(IVF-ET)后妊娠早期阴道流血的发生率及其对妊娠结局的影响.方法 回顾性分析行IVF-ET或胚胎解冻-移植(F-ET)获得临床妊娠 823例患者的临床资料,分析早期阴道流血与患者年龄、不孕年限、体质量指数(BMI)、孕酮及人绒毛膜促性腺激素水平、不孕类型、流产、妊娠期并发症、早产及剖宫产率的相关性.结果 ①妊娠早期阴道流血发生率为23. 69％,多元回归分析结果显示妊娠早期阴道流血与妊娠期并发症的发生明显相关,差异有统计学意义(OR=2.90,95％ CI: 1. 85～ 4. 57,P<0.05),与流产、早产及剖宫产率无明显相关;②患者孕前BMI是影响剖宫产的独立危险因素(OR=1.09,95％ CI:1.02～1. 17,P<0.05). 结论 IVF/F-ET后妊娠早期阴道流血对妊娠结局如流产、早产率无明显影响,但与妊娠期并发症的发生密切相关.     

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.