早中孕期有关血清筛查指标与子痫前期的相关性研究

目的探究早中孕期产前筛查血清指标浓度水平与子痫前期发生的相关性。方法对纳入本次研究的孕妇检测早孕期血清中妊娠相关性血浆蛋白A(PAPP-A)、游离β绒毛膜促性腺激素(Freeβ-h CG),中孕期甲胎蛋白(AFP)、Freeβ-h CG和游离雌三醇(u E3);并比较子痫前期孕妇与正常孕妇上述筛查指标的水平差异。结果调查产前筛查和妊娠结局完整的孕妇7 674人,妊娠期高血压疾病发生率为8.70%,子痫前期发生率为3.39%。子痫前期孕妇早孕期PAPP-A和Freeβ-h CG水平均低于正常孕妇(P0.05),尤其早发型子痫前期孕妇早孕期PAPP-A水平明显低于同期正常孕妇的水平,其在早孕期诊断早发型子痫前期的准确性在ROC曲线下面积达0.823;中孕期AFP、Freeβ-h CG和u E3在子痫前期与正常孕妇间差异均无统计学意义(P0.05)。结论早孕期PAPP-A水平对诊断早发型子痫前期有一定价值,中孕期血清筛查指标对子痫前期无明显临床价值。     

妊娠早期血清学指标联合子宫动脉血流动力学指标预测子痫前期

目的 探讨早孕期妊娠相关血清蛋白A(PAPP-A),游离β-人绒毛膜促性腺激素(Free-β-hCG)及双侧子宫动脉血流动力学指标联合预测子痫前期的价值.方法 随机选择2014年1月至2015年1月在西安交通大学第一附属医院及陕西省第四人民医院产科门诊进行正规产前检查的孕9周至孕12周的单胎孕妇960例.分别检测PAPP-A、Freeβ-hCG及子宫动脉血流动力学指标(PI、RI、S/D).结果 ①PAPP-A预测子痫前期的灵敏度为75.00%,特异度96.79%;Free-β-hCG灵敏度78.57%,特异度为96.22%;②子宫动脉PI、RI及S/D的灵敏度分别为74.65%、70.27%、77.27%,特异度为别为95.97%、95.83%、97.04%;③PAPP-A、Free-β-hCG及子宫动脉血流联合预测子痫前期灵敏度86.21%,特异度95.67%,约登指数为0.82.结论 早孕期血清PAPP-A、Free-β-hCG及子宫动脉血流动力学指标联合应用对孕期发生子痫前期具有更高的预测价值.     

子痫前期患者循环及胎盘组织中VEGF-A、PIGF、PEDF的表达

目的探讨循环和胎盘组织中血管内皮生长因子(VEGF)-A、胎盘生长因子(PIGF)和色素上皮衍生因子(PEDF)表达与子痫前期发病的关系。方法选取2015-2016年在江西省妇幼保健院分娩的子痫前期患者45例为研究组,同期在该院分娩的正常孕妇30例为对照组。ELISA法检测孕妇循环VEGF-A、PIGF、PEDF表达。Western Blot法检测胎盘VEGF-A、PIGF、PEDF表达。结果研究组患者循环和胎盘组织中PEDF表达高于对照组,而VEGF、PIGF表达低于对照组,差异均有统计学意义(均P<0. 05)。结论子痫前期存在促进/抑制血管生长因子平衡紊乱。PEDF表达异常在子痫前期发病过程中可能起着特殊作用。     

联合检测妊娠早中期孕妇血清β-hCG、PAPP-A、sFlt-1及PLGF对预测子痫前期的意义

目的探讨联合检测妊娠早中期孕妇血清β-人绒毛膜促性腺激素(β-h CG)、妊娠相关α血浆蛋白(PAPP-A)、可溶性血管内皮生长因子受体-1(s Flt-1)及胎盘生长因子(PLGF)对预测子痫前期的意义,为临床预测子痫前期提供参考依据。方法选取2016年1月-2017年6月间该院收治的40例子痫前期患者作为观察组,同期选取40例正常妊娠女性作为对照组,使用酶联免疫吸附法检测血清中β-h CG、PAPP-A、s Flt-1及PLGF水平;以病理学检测结果作为诊断金标准,分析各指标诊断子痫前期的诊断效能,绘制ROC曲线评估各指标预测价值。结果观察组患者血中β-h CG、s Flt-1及PLGF水平显著高于对照组,差异有统计学意义(P0.05),观察组患者血中PAPP-A水平显著低于对照组,差异有统计学意义(P0.05);新生儿出生时体质量与孕产妇体内β-h CG及PLGF水平显著相关(P0.05),新生儿1 min Apgar评分与孕产妇体内s Flt-1水平显著相关(P0.05),分娩孕周与孕产妇体内PAPP-A及PLGF水平显著相关(P0.05);β-h CG诊断阳性共36例,阴性44例;PAPP-A诊断阳性35例,阴性45例;s Flt-1诊断阳性共34例,阴性46例;PLGF诊断阳性共36例,阴性44例;联合诊断阳性41例,阴性39例;联合诊断的灵敏度、特异度、阳性预测值、阴性预测值及准确率均显著高于各指标单独检测,差异有统计学意义(P0.05),且联合诊断ROC曲线下面积为0.993,显著高于β-h CG、PAPP-A、s Flt-1及PLGF的0.884、0.728、0.801及0.768。结论联合检测妊娠早中期孕妇血清β-h CG、PAPP-A、s Flt-1及PLGF可有效提高预测子痫前期的准确性,并可作为临床中筛查该疾病的重要方法。     

子痫前期患者血浆D-二聚体和纤维蛋白原检测的应用探讨

目的研究子痫前期患者血浆D-二聚体、纤维蛋白原水平变化及其诊断价值,为患者的临床诊疗提供指导。方法选取2017年1月-2018年9月在该院门诊接受产前检查的50例子痫前期孕妇作为观察组,另选择同期在该院进行产前检查的50例健康孕妇作为对照组。依据子痫前期病情严重程度将观察组孕妇分为轻度子痫前期组(30例)与重度子痫前期组(20例)。比较孕妇D-二聚体、纤维蛋白原水平并分析其临床意义。结果重度子痫前期组孕妇D-二聚体水平明显高于对照组与轻度子痫前期组,差异有统计学意义(P0. 05)。轻度子痫前期组孕妇D-二聚体与纤维蛋白原水平明显高于对照组,差异有统计学意义(P0. 05)。重度子痫前期组孕妇纤维蛋白原水平明显低于轻度子痫前期组孕妇(P0. 05),重度子痫前期组孕妇纤维蛋白原与对照组孕妇比较,差异无统计学意义(P0. 05)。纤维蛋白原的特异度与准确度明显低于D-二聚体与两项阳性检测结果的特异度,差异有统计学意义(P0. 05)。D-二聚体的灵敏度明显低于纤维蛋白原与两项阳性检测结果的灵敏度,差异有统计学意义(P0. 05)。D-二聚体阳性预测值明显高于纤维蛋白原阳性率预测值,差异有统计学意义(P0. 05)。D-二聚体阳性预测值与两项阳性预测值相比,差异无统计学意义(P0. 05)。结论 D-二聚体水平可以作为子痫前期的早期有效诊断指标,而纤维蛋白原可以在子痫前期患者被明确诊断的前提下作为监测病情的指标。     

子宫动脉血流阻力指数联合胎盘体积在评估早发型子痫前期中的应用

目的探讨子宫动脉血流阻力指数(RI)值联合胎盘体积在评估早发型子痫前期中的应用效果。方法选取广东省妇幼保健院确诊的早发型子痫前期孕妇68例作为观察对象,其中早发型轻度子痫前期37例(轻度组),早发型重度子痫前期31例(重度组),另取同期产检健康孕妇35例作为对照组。比较3组孕妇的血流RI值,胎盘大小,并采用ROC评价RI值联合胎盘大小在评估早发型子痫前期的价值。结果轻度组和重度组的胎盘体积均小于对照组孕妇,RI值则均高于参照组(均P0. 05),且重度组的胎盘体积均小于轻度组,RI值则高于轻度组(P0. 05),ROC曲线显示,联合血流RI值、胎盘最长径及最短径在预测早发型子痫前期中的灵敏度、特异度及曲线下面积均明显高于参考值(P0. 05)。结论子宫动脉血流RI值联合胎盘大小在评估早发型子痫前期的灵敏度和特异度均较高,价值良好,可作为评估早发型子痫前期的参考指标。     

子痫前期患者PON1活性和AOPP水平及对疾病严重程度的影响

目的探讨子痫前期患者对氧磷酶1 (PON1)活性和晚期氧化蛋白产物(AOPP)水平及对疾病严重程度的影响。方法选择2014年6月1日-2017年6月1日邢台市第三医院及邢台市人民医院收治的120例子痫前期患者,根据疾病严重程度分为轻度子痫前期(MPE) 60例和重度子痫前期(SPE) 60例。选择同期接受产前检查和住院的60例健康产妇为对照组。采用乙酸苯酯法检测3组血清PON1活性,采用ELISA检测血清AOPP水平,采用RT-PCR测定胎盘组织中PON1 mRNA、AOPP mRNA水平。比较3组患者血清PON1活性、AOPP水平和胎盘组织中PON1 mRNA、AOPP mRNA水平。结果 MPE组及SPE组患者血清PON1活性及胎盘组织中PON1 mRNA水平均显著低于对照组患者(均P0. 05),且SPE组患者血清PON1活性及胎盘组织中PON1 mRNA水平均显著低于MPE组患者(均P0. 05); MPE组及SPE组患者血清AOPP水平及胎盘组织中AOPP mRNA水平均显著高于对照组患者(均P0. 05),且SPE组患者血清AOPP水平及胎盘组织中AOPP mRNA水平均显著高于MPE组患者(均P0. 05)。PON1及AOPP联合检测子痫前期的准确性、灵敏度、特异度明显高于PON1或AOPP单一检测结果。结论PON1及AOPP表达水平与子痫前期患者的发病和严重程度相关,联合检测PON1和AOPP能有效提高诊断的灵敏度和特异度,对临床诊治具有明显的指导意义。     

PAPP-A、sFlt-1、TTR在妊娠期高血压疾病诊断中的价值

目的探讨妊娠相关蛋白A(PAPP-A)、可溶性血管内皮生长因子(sFlt-1)、中转甲状腺素蛋白(TTR)联合检测对于鉴别诊断妊娠期高血压疾病的临床价值。方法选取2018年1月至2019年12月在徐州医科大学附属沭阳医院确诊的妊娠期高血压疾病孕妇88例作为病例组,选取同期正常妊娠的孕妇120例作为对照组,检测两组孕妇于孕24~28周的PAPP-A、sFlt-1、TTR水平,并按照患者病情将病例组分为妊娠期高血压组、轻度子痫前期组、重度子痫前期组,采用受试者工作特征曲线(ROC)分析3项指标单独和联合检测鉴别诊断妊娠期高血压疾病的价值。结果病例组的PAPP-A水平显著高于对照组(t=2.254,P<0.05),病例组的sFlt-1、TTR水平显著低于对照组(t值分别为-3.226、-17.907,均P<0.05);妊娠期高血压组、轻度子痫前期组、重度子痫前期组患者的PAPP-A、sFlt-1、TTR水平比较差异均有统计学意义(F值分别为3.624、3.525、7.037,均P<0.05);PAPP-A、sFlt-1、TTR联合检测诊断妊娠期高血压疾病的灵敏度为97.15%、特异度为86.49%、漏诊率为2.85%、误诊率为13.51%,ROC曲线下面积AUC值为0.935。结论PAPP-A、sFlt-1、TTR这3项指标联合检测鉴别诊断妊娠期高血压疾病具有重要的临床价值。     

血清UA、TG水平与孕妇子痫前期发病风险的相关性

目的探讨子痫前期(PE)孕妇体内尿酸(UA)、三酰甘油(TG)水平,探讨其与PE发病风险的相关性,为进一步提高该病的临床预测和诊断提供有价值的信息。方法回顾性分析2018年1月-2019年2月在该院正规建卡并于孕中晚期确定为PE的32例孕妇的临床资料(研究组),并随机选取同时期内正规建卡的健康孕妇68例作为对照组。比较研究组和对照组孕妇孕期一般情况和UA、TG水平;将研究组患者根据病情严重程度分为重度PE组(8例)和轻度PE组(24例),比较两组UA、TG水平,并分析UA、TG与PE严重程度和临床症状的相关性;多因素分析子痫前期发病危险因素,ROC曲线分析比较UA、TG水平检测对PE早期的诊断和预测价值。结果研究组UA、TG高于对照组(P0. 05);重度PE组UA、TG水平高于轻度PE组(P0. 05),且UA、TG水平与病情严重程度呈显著正相关(P0. 05); UA、TG与PE临床症状呈显著正相关(P0. 05); UA、TG为子痫前期患者发病危险因素(P0. 05); UA、TG联合检测对子痫前期患者疾病预测和诊断价值显著优于单独检测(P0. 05)。结论可通过检测孕期UA、TG水平变化来预测和诊断PE发生和发展,二者联合检测可进一步提高对PE的预测和诊断能力。     

血清PLGF、PAPP-A、β-HCG与妊娠期高血压疾病的相关性及预测不良妊娠结局价值

目的：探讨孕妇胎盘生长因子(PLGF)、妊娠相关血浆蛋白-A(PAPP-A)、人绒毛膜促性腺激素(β-HCG)表达及与妊娠期高血压疾病的相关性。方法：选取2019年2月—2021年7月在本院建档并定期产前检查的妊娠期高血压疾病患者127例(病例组),分为妊娠期高血压组、子痫前期轻度组和子痫前期重度组,正常孕妇160例为对照组。采用酶联免疫吸附法检测血清PLGF、PAPP-A水平,全自动化学发光免疫分析仪检测血清β-HCG水平;Pearson法分析血清PLGF、PAPP-A、β-HCG与妊娠期高血压疾病患者不良妊娠结局的相关性,受试者工作特征曲线分析其预测不良妊娠结局价值,logistic回归分析发生影响因素。结果：妊娠高血压组、子痫前期轻度组、子痫前期重度组血清PAPP-A、β-HCG水平依次升高且均高于对照组,PLGF表达水平依次降低且均低于对照组(均P<0.05)。病例组发生胎儿生长受限、胎儿窘迫、早产比例高于对照组(P<0.05);不良妊娠结局患者血清PLGF表达水平低于良好妊娠结局组,血清PAPP-A、β-HCG水平高于良好妊娠结局组(均P<0.05)。血清P...     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.