临洮县2001～2008年孕产妇死亡原因分析

目的：为了进一步提高产科质量,降低孕产妇死亡率,及时了解分析我县孕产妇死亡率和死亡的影响因素,总结经验教训,制定干预措施,为降低我县孕产妇死亡率打下基础。方法：收集临洮县死亡孕产妇人数40例,进行了回顾性分析及统计,寻找死亡原因。结果：孕产妇平均死亡率99．01／10万．主要原因是产科出血、内科合并症。结论：加强围产期保健,强化县乡两级产科建设管理及人员培训,实行高危孕产妇的筛查管理、转诊,建立有效的高危孕产妇急救绿色通道,达到对高危孕产妇诊断准确、转送接诊及时的有效运转系统,是降低孕产妇死亡率的有效措施。     

探讨深圳市沙井镇2001～2005流动人口孕产妇死亡原因及影响因素

目的探讨流动人口孕产妇死亡原因及影响因素，为降低孕产妇死亡率制定有关政策与措施提供依据。方法对深圳市沙井镇2001～2005年8例死亡的流动人口孕产妇进行死因及相关因素分析。结果深圳市沙井镇5a内活产总数18469例，孕产妇死亡率平均为43．32／10万，流动人口死亡率占53．53／10万。孕产妇死亡原因前3位为羊水栓塞、产科出血、妊娠高血压疾病，而流动人口孕产妇死亡率与与文化程度、计划生育、接生法、怀孕次数、分娩次数和产前检查密切相关。结论加强流动人口孕产妇管理，是杜绝非法接生，提高围产期保健质量，控制流动人口孕产妇死亡率的有效措施。     

对2007年～2011年宝鸡市孕产妇死亡情况的回顾性分析

目的:分析宝鸡市孕产妇死亡和死因变化规律,提出降低孕产妇死亡率的干预措施。方法:对我市5年孕产妇死亡资料进行回顾性分析。结果:宝鸡市5年孕产妇死亡率平均为26.19/10万,整体呈逐年下降趋势。死因前4位依次为产科出血、羊水栓塞、妊娠期高血压疾病、妊娠合并内科疾病。结论:加强孕产期保健及系统管理,尤其是高危孕妇的筛查、转诊及分级管理,强化产科急救、转诊能力的培训,加强产科与多学科间的协作,加大健康教育力度,可有效降低孕产妇死亡率。     

临洮县2001-2006年孕产妇死亡原因分析

目的:为了进一步提高产科质量,降低孕产妇死亡率,及时了解分析临洮县孕产妇死亡率和死亡的影响因素,总结经验教训,制定干预措施,为降低孕产妇死亡率打下基础。方法:收集2001~2006年临洮县死亡孕产妇32例,进行回顾性分析及统计,寻找死亡原因。结果:2001~2006年的孕产妇平均死亡率108.00/10万,主要原因是产科出血、内科并发症。结论:加强围产期保健,强化县乡两级产科建设管理及人员培训,实行高危孕产妇的筛查管理、转诊,建立有效的高危孕产妇急救绿色通道,对高危孕产妇诊断准确、转送接诊及时,是降低孕产妇死亡率的有效措施。     

产科出血致孕产妇死亡9例分析

目的:探讨孕产妇产科出血原因,为制定降低孕产妇死亡率的干预措施提供依据。方法:对产科出血致孕产妇死亡个案及评审结果进行分析。结果:产科出血仍是孕产妇死亡的主要原因。产妇在家中分娩、农村接生波接生、孕妇未接受孕期保健管理、未住院分娩、乡村医生医技水平低等因素影响了死亡率的上升。结论:取缔农村接生员、禁止家庭接生、加强孕期保健管理、提高高危筛查率和农村贫困孕产妇住院分娩率,强化妇幼保健人员适宜技术培训,提高县乡级产科质量和急救能力,降低产科出血发生率,方能降低孕产妇死亡率。     

探析导致孕产妇死亡的原因及对其进行干预的措施

目的：探讨分析导致孕产妇死亡的原因及对其进行干预的措施,旨在为进一步提高产科护理工作的质量提供理论依据,降低孕产妇的死亡率,保障母婴安全。方法：选取2008年～2012年间庐江县死亡孕产妇15例作为研究对象,对其死亡的原因进行回顾性分析。结果：2008～2012年的孕产妇平均死亡率25.87/10万,主要原因是产科出血及内科合并症。结论：加强产科建设管理及人员培训,落实高危孕产妇的管理和转诊制度,畅通危重孕产妇急救绿色通道,对高危孕产妇的及时转送和接诊,是降低孕产妇死亡率的有效措施。     

珠海市1986-2005年孕产妇死亡情况分析

目的回顾珠海市20年来孕产妇的死亡率及死因，分析总结在降低孕产妇死亡率工作中的经验与不足，提出改进措施。方法将珠海市1986-2005年孕产妇死亡情况进行统计、比较、分析。结果①1986-2005年珠海市本地人口孕产妇平均死亡率为25．85／10万，1996-2005年珠海市本地人口与流动人口的孕产妇平均死亡率分别为28．54／10万、78．64／10万。②1986-2005年全市住院分娩率由最低点76．12％逐年上升到99．81％。③孕产妇的主要死因，前10年是产科出血、妊高征、妊娠合并内科疾病；后10年加强了产科建设及高危妊娠的筛查，死亡病种发生了变化，出现病毒性肝炎、麻醉意外、异位妊娠等新病种，羊水栓塞居第一位，20年间以产科出血为死亡原因的孕产妇死亡率逐年下降，产科出血退居第三位。④计划外妊娠占47．7％，无产检占67％，家庭接生占21．1％，家中死亡占52．6％；农村死亡高于城市，分别为65．56％、34．44％。⑤1996-2005年死亡孕产妇的文化程度以初中小学所占42．4％，家庭经济月收入小于100元以下占67．74％。年龄以25～29岁年龄组占40％。创造条件可避免死亡占48．39％。结论重视流动人口的孕产妇保健管理，加强健康教育，加大《中华人民共和国母婴保健法》的执法力度，杜绝非法接生，加强临床医生的专业知识和急救技能培训，充分发挥市孕产妇重症救治中心的作用，是降低我市孕产妇死亡的关键。     

宁夏西吉县2003-2012年孕产妇死亡原因分析

目的探讨西吉县孕产妇死亡的原因,提出有效干预措施和方法,进一步降低孕产妇死亡率。方法对西吉县2003-2012年10年间死亡的53例孕产妇进行回顾性分析。结果西吉县孕产妇死亡率从2003年的107.05/10万下降至2012年的39.64/10万,平均死亡率为68.82/10万。10年间呈现逐年下降趋势,主要死亡原因是产科出血、妊娠高血压疾病、妊娠合并心脏病和妊娠合并重症肝炎。结论降低孕产妇死亡的关键是加强高危孕产妇的筛查和管理,加强医务人员的责任性,提高产科质量,建立孕产妇急救绿色通道,进一步加大项目支持。     

涪陵区1990—2009年孕产妇死亡分析

目的了解涪陵区1990—2009年20年间孕产妇死亡率和住院分娩率的变化趋势,为制定有效降低孕产妇死亡率的干预措施提供科学依据。方法对涪陵区1990—2009年的187例孕产妇死亡调查报告进行整理分析。结果20年来,我区的孕产妇死亡率呈逐年下降趋势,住院分娩率呈明显上升趋势,后10年（2000。2009年）与前10年（1990—1999年）比较：计划外生育死亡的比例明显增高,产褥感染致死率已明显下降,在家中和转运途中死亡呈现明显下降趋势;由于转变了村卫生室的职能,由乡村医生接生导致的死亡率则明显下降。20年来产科出血仍是我区首位的孕产妇死亡原因,在乡卫生院住院分娩导致的死亡呈增加趋势。结论积极采取措施控制计划外生育,加强高危妊娠管理,提高基层产科人员业务素质,及时启动急救绿色通道,降低产科出血,及时治疗妊娠并发症和合并症,增强群众自我保健意识是降低孕产妇死亡率的重要措施。     

青海省海北州二县1997～2001年孕产妇死亡相关因素分析

目的 掌握海北州孕产妇死亡情况，了解孕产妇死亡的主要原因，为有效降低孕产妇死亡率提供理论依据。方法 引用海北州1997～2001年孕产妇死亡报告资料进行现况研究。结果 海北州刚察县、海晏县孕产妇死亡率高于全国平均水平。非新法接生率高、孕产妇系统管理率低、医疗卫生条件差等因素是导致二县孕产妇死亡率高的主要原因。孕产妇死因以产科出血、妊高征和内科合并症为主。结论 重视防治产科出血，提高产科质量，进一步做好围产保健工作，加强孕产妇管理，尤其是加强对高危孕妇的专案管理，以及提高孕产妇住院分娩率、杜绝土法接生等是有效降低当地孕产妇死亡率的关键环节。     

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.