孕产妇（社区）主要心理问题及相关因素研究

目的 分析社区孕产妇存在的主要心理问题及其相关因素.方法 回顾分析2007-2013年北京某社区8 662例孕产妇心理测试结果.结果 8 662例孕产妇中,有5 916例存在不同程度的心理问题,占总数的68.3％,主要表现为躯体化不适症状、强迫、人际关系障碍、焦虑、抑郁和恐惧感等;心理不良状况与孕产妇的年龄、职业、文化程度、不良孕产史、初产和孕期异常疾病等因素相关.结论 社区孕产妇心理健康状况值得关注,从社区保健开始做好孕产期心理保健,能改善其焦虑和抑郁等不良心理情绪,提高孕产期保健质量,促进母婴健康.     

孕期抑郁的社会心理相关因素研究

目的对孕期抑郁的相关社会心理因素进行探讨和研究,做好孕妇的心理和精神护理工作。方法对我院2010年1月至2013年1月收治120例孕妇采用问卷调查和抑郁自评量表对影响孕妇孕期抑郁的因素进行调查和分析。结果不同孕期的孕妇SCL-90症状因子得分不同,心理异常的发生率也不同。调查结果发现夫妻关系不融洽、不和谐是引起孕妇心理问题最重要的危险因素;缺乏家人关心和帮助是造成孕妇心理问题的次要危险因素;经济状况不佳、丈夫或自己工作前景不佳及收入不稳定是造成孕妇出现心理问题的重要危险因素。结论孕期妇女易产生各种心理问题,与社会、家庭、个人等因素联系紧密,需做好孕期妇女心理问题的防护工作,保障孕期妇女的心理和生理健康。     

孕产妇的心理护理

<正>孕产妇能否顺利完成孕产期这一生理过程,与孕产妇的心理状态有密切的关系。正确的心理护理,可使孕产妇情绪稳定、精神放松、产程缩短、难产减少、乳汁分泌旺盛、为母子健康打下良好的基础。因此根据孕产妇不同时期不同心理状态,给予适时的心理护理,尤为重要。1孕期的心理护理     

孕产妇妊娠合并缺铁性贫血的原因分析以及护理干预

目的探讨孕妇妊娠合并缺铁性贫血的原因分析以及护理干预情况。方法以2013年4月1日至2014年4月1日,在我站参加孕产妇系统管理中筛查出的151例合并贫血的孕妇为调查对象,制定统一的调查表进行调查,进行相关内容分析,通过实验室血细胞分析和血清铁的检查能及时发现妊娠期缺铁性贫血。结果不良的饮食习惯及生活方式,宣传不到位,受教育程度低,生活质量低,遵医行为不良等因素是构成贫血的原因。结论通过对妊娠合并贫血的孕产妇进行系统管理、产期保健及合理调整饮食结构、注意孕期营养、补充铁剂等干预,对妊娠期妇女各个阶段进行了全方位的精心护理,绝大多数贫血孕妇安全度过了整个孕产期,降低了孕产妇及新生儿不良反应的发生。     

妇女孕期保健知识 态度 行为对妊娠结局的影响

目的探讨孕期保健对妊娠结局的影响,为开展有针对性的保健工作提供依据。方法采用病例对照研究方法,对155名正常产及174例不良妊娠结局的孕产妇进行问卷调查,调查其孕期保健知识、态度及行为。结果不良妊娠结局孕产妇孕期保健KAP得分水平不高,孕期保健知识,态度、行为合格率分别为：19.5%、16.1%、15.7%,且与正常产孕产妇间都存在显著的统计学差异（P≤0.05）。结论不良妊娠结局的孕产妇孕期保健KAP得分不高,应重视和加强孕期保健工作,以便减少异常妊娠的发生。     

浅谈孕产妇贫血相关因素及对妊娠结局的影响

目的：探讨孕产妇贫血相关因素及对妊娠结局的影响。方法：本文就我院1650例贫血孕产妇临床资料进行回顾性分析，探讨其影响因素，为临床识别、监测和及时干预提供临床依据。结果：孕妇的年龄、职业、教育程度、人均月收入、孕周、孕期体质量指数、偏食、经期天数、月经量、孕期营养宣教、流产次数、生育次数、产后出血、早孕反应、三餐结构和营养素补充(铁、锌、维生素类和优质蛋白等)是妊娠贫血的影响因素。结论：应积极防治妊娠期贫血，加强孕妇健康教育和贫血危害性的宣传工作；加强孕产期保健，做好孕妇的营养指导和营养宣传，帮助孕妇建立科学合理的膳食习惯；合理控制孕期体重；定期产前检查，及时发现和应对妊娠期贫血；妊娠4个月起常规补充铁剂，降低孕妇贫血发生率。     

孕产妇入院后健康教育的重要性

孕产期健康教育就是通过有计划、有组织、有系统的各项活动,指导孕产妇及其家人树立健康意识、养成良好的行为习惯和生活方式,降低或消除影响孕产期健康的危险因素,促进母婴健康、保障母婴安全。     

妊娠期妇女膳食及营养与妊娠结局相关研究分析

目的了解中晚期妊娠妇女的生活饮食习惯及膳食营养状况,探讨其与妊娠结局的关系,并对不良妊娠结局的影响因素进行分析,旨在提高妊娠妇女健康及合理营养,为围生期保健提供科学合理的膳食营养指导措施。方法对2008年1月～2009年12月清远市妇幼保健院1000例中晚期妊娠妇女,运用病例对照研究,随机抽取500例有膳食不均的孕产妇为观察组,随机抽取500例膳食均衡的孕产妇为对照组,采用妊娠妇女健康问卷、膳食调查及营养评定,追踪随访妊娠中晚期妊娠结局,比较两组孕妇对母儿影响情况。结果影响妊娠膳食合理营养的因素有:孕期体质量指数、偏食、孕期营养宣教、三餐结构、营养素补充、月收入低、早孕反应。与对照组比较,膳食不平衡导致胎儿生长受限(FGR)、妊娠期糖尿病、妊娠期贫血、妊娠期高血压疾病、胎儿窘迫、产后出血、胎膜早破、巨大胎儿、低体重儿、早产、流产、死胎及畸胎发生率均显著高于对照组(P0.05)。结论膳食不均导致妊娠期不合理营养均可导致孕妇本身及其后代的不良结局,妊娠期合理膳食营养,可提高母婴健康水平。     

妊娠期糖尿病27例治疗体会

目的：探讨妊娠期糖尿病对孕产妇及围产儿预后的影响。方法：分析7年来住院分娩27例妊娠期糖尿病孕妇及27例无并发症孕妇,对其孕产期并发症、血脂水平、体重、围产儿预后及分娩方式进行对比分析。结果：妊娠期糖尿病组的妊娠期高血压疾病发病率、胎膜早破发病率、剖宫产率、血脂水平、体重、围产儿发病率均增高。结论：妊娠期糖尿病孕产期并发症、血脂水平、体重、剖宫产率、围产儿并发症均增高。故应加强孕期保健、认真指导孕妇饮食、控制孕妇体重增加,及时发现、及时处理妊娠期糖尿病,对改善孕产妇及围产儿预后有很大影响。     

304例孕妇心理健康状况调查

目的:探讨妊娠期妇女心里健康状况,并提出护理对策.方法:采用焦虑自评量表(Self-rating anxiety scale, SAS)、抑郁自评量表(Self-rating depression scales,SDS)对304例孕妇进行问卷调查.结果:孕期具有焦虑或抑郁症状的身心障碍者共89例,占29.3%.进行单因素分析,结果显示孕期有服药史、有过自然流产史、死胎史、新生儿死亡史、孕期并发症、孕期合并症、丈夫是否盼望男孩等共19项因素与孕期焦虑有关(P<0.05);孕期有服药史、有过死胎史、新生儿死亡史、孕期并发症、孕期合并症、孕期增重过多等16项因素与孕期抑郁有关(P<0.05).结论:孕妇存在明显的负性情绪,应有针对性的进行心理干预,以使母婴平安度过分娩期.同时对孕产妇的心理护理应提前到孕期乃至孕前,应加强社会工作,才能真正减少孕妇的不良情绪反应.     

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.